NAC287.318. Enrollment forms: Required information.

Latest version.

Enrollment forms that are submitted to the Program must include, without limitation:

1. The name, address, social security number, if any, and signature of the person who is enrolling in the Program; and

2. The name and social security number, if any, of any dependent that the person chooses to cover under the Program.

(Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R109-12, 12-20-2012)

                    
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