PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form CDPH8738
for the current year.
Form CDPH8738 Acknowledgement of Policies and Responsibilities - Health Insurance Premium Payment (HIPP) Program - Family Plan - California
What Is Form CDPH8738?
This is a legal form that was released by the California Department of Public Health - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the CDPH8738 form?
A: The CDPH8738 form is the Acknowledgement of Policies and Responsibilities form for the Health Insurance Premium Payment (HIPP) Program Family Plan in California.
Q: What is the Health Insurance Premium Payment (HIPP) Program?
A: The Health Insurance Premium Payment (HIPP) Program is a program in California that assists eligible families in paying for their health insurance premiums.
Q: What is the purpose of the CDPH8738 form?
A: The purpose of the CDPH8738 form is to acknowledge and confirm the policies and responsibilities of participants in the HIPP Program Family Plan.
Q: What does the CDPH8738 form cover?
A: The CDPH8738 form specifically covers the HIPP Program's Family Plan, which provides assistance for health insurance premiums for eligible families.
Q: Who needs to fill out the CDPH8738 form?
A: The CDPH8738 form needs to be filled out by participants in the HIPP Program Family Plan in California.
Form Details:
- Released on January 1, 2018;
- The latest edition provided by the California Department of Public Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CDPH8738 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
