If there is any note, Please add it in the box
NOTE: If you plan on filing income tax with your kids/dependents (we need the Full name, Gender, Date of birth, and immigration/citizenship status)
Please Include your spouse and tax dependents even if they don't need health Insurance coverage.
If you plan to claim someone as a tax dependent for the year you want coverage, Please include them on your application.
If you won't claim them as a tax dependent, don't include them.