Attention: All Hazardous Duty Members including Medicare and Non-Medicare Eligible: Hazardous Duty Retirees that are either Medicare or Non-Medicare Eligible are required to submit the Form 6256 (Designation of Spouse and/or Dependent Child for Health Insurance Contribution) This is a yearly requirement during open enrollment. This applies ONLY to Hazardous Duty, General Assembly or Fred Capps recipients that are on the Medicare Plans or the Non-Medicare plans, covering their spouse and eligible dependents.