Health Insurance Form Templates

ADVERTISEMENT

Documents:

681

  • Default
  • Name
  • Form number
  • Size

This form is used for creating a biographical list of life and health insurance administrators in Arizona.

This document is a request for information form that is used when trying to gather information from a health insurer in Arizona. It is used to request specific details and documentation related to health insurance coverage.

This form is also known as the healthcare marketplace tax form. It is used to inform the IRS about individuals and families enrolled in a health plan via the Health Insurance Marketplace.

This form is filed by employers with 50 or more full-time employees in order to provide information about their enrollment in health coverage required under sections 6055 and 6056 of the Internal Revenue Code.

This form is used for individuals in Arizona to apply for a Certificate of Eligibility for the Health Insurance Premium Tax Credit. It helps determine if an individual is eligible for a tax credit to help pay for health insurance premiums.

This document provides information about an increase in rates for health and accident insurance in the state of Mississippi.

This document is used for enrolling in a universal group outside of the Idaho Exchange in Idaho.

This document provides information about health coverage options available to employees in the state of New Mexico. It outlines the various plans and benefits offered and explains how employees can enroll and access these benefits.

This Form is used for updating health insurance information for individuals residing in New York.

This Form is used for requesting prior authorization for otological medical procedures in the state of Wisconsin. It includes a physician report on the patient's condition and treatment plan.

This Form is used for applying to the T.J. Anthony Catastrophic Illness Program Family Member (CIP-FM) in the City and County of San Francisco, California.

Loading Icon