check the appropriate box indicating single,family or waived.you may waive extended health and dental benefits only if you have coverage elsewhere through your spouse.you must indicate the insurance company name and policy number,if you wish to waive

check the appropriate box indicating single,family or waived.you may waive extended health and dental benefits only if you have coverage elsewhere through your spouse.you must indicate the insurance company name and policy number,if you wish to waive
check the appropriate box indicating single,family or waived.you may waive extended health and dental benefits only if you have coverage elsewhere through your spouse.you must indicate the insurance company name and policy number,if you wish to waive this coverage.
在单身、家庭或放弃框中选择相应的框。如果通过你的配偶你已经在别的地方享受到扩展的健康和牙医福利，你也可以放弃此申请。you must indicate the insurance company name and policy number,if you wish to waive this coverage.

check the appropriate box indicating single,family or waived.you may waive extended health and dental benefits only if you have coverage elsewhere through your spouse.you must indicate the insurance company name and policy number,if you wish to waive
请检查显示单身,家庭或者放弃相对应的框,除非你通过配偶拥有其他的保险,否则你可能放弃额外的健康和牙医福利.如果你希望放弃该保险,请务必标明保险公司的名称和保单号.

请选中相应的框，显示单一，家人或豁免。除非您有其他地方的覆盖面,您可能会放弃延长健康及牙科福利的，通过你的配偶。如果你想放弃这个范围，您必须指出保险业的公司名称和投保的数目。

请选中相应的框，显示单一，家人或豁免。您可能会放弃延长健康及牙科福利的唯一如果您有其他地方的覆盖面，通过你的配偶。您必须指出，保险业的公司名称和政策的数目，如果你想放弃这个范围。