To remove a Spouse or Dependent from your Membership, complete this form: Member Exclusion Form.
Spouse Exclusion:
When completing the above mentioned form it will require an email address for your spouse. This will send an automatic email notification to the Spouse, requesting approval to remove them from the Membership. Spousal exclusion will not process until Solidarity HealthShare has received approval in writing from the Spouse being removed.
Dependent Exclusion:
No Dependent approval necessary, the request will be processed.
Reminder: All Membership changes need to be received by the first day of the month prior to the desired effective date.
To exclude the Primary Member on the Membership or roll-off a dependent onto their own Membership, please complete the Primary Member or Roll-Off Membership Change Form instead.
FINAL NOTE:
The Member Exclusion Form will remove a Member from the Membership Household.
The Primary Member or Roll-Off Membership Change Form will remove the Member from the original Membership Household and create a new Membership ID for the Member being removed, or Rolled-Off.