Form DOH-4411 Tpa / Aso Client List Addendum - Deletions - New York

Form DOH-4411 Tpa / Aso Client List Addendum - Deletions - New York

What Is Form DOH-4411?

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DOH-4411?
A: Form DOH-4411 is a document used in New York regarding TPA/ASO client list addendum.

Q: What is TPA?
A: TPA stands for Third Party Administrator, which is a company that manages employee benefits on behalf of employers.

Q: What is ASO?
A: ASO stands for Administrative Services Only, which is an arrangement where an employer self-funds their employee benefits and hires an external company to administer the benefits.

Q: What is the purpose of the TPA/ASO client list addendum?
A: The TPA/ASO client list addendum is used to update the client list of a TPA or ASO in relation to Form DOH-4411.

Q: What does 'addendum - deletions' mean?
A: 'Addendum - deletions' refers to the section of the form where any clients that are being removed from the TPA or ASO client list are listed.

Q: Who uses Form DOH-4411?
A: Form DOH-4411 is used by TPAs and ASOs in New York to update their client lists with the Department of Health.

Q: Is Form DOH-4411 specific to New York?
A: Yes, Form DOH-4411 is specific to the state of New York.

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Form Details:

  • Released on May 1, 2012;
  • The latest edition provided by the New York State Department of 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 printable version of Form DOH-4411 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.

Download Form DOH-4411 Tpa / Aso Client List Addendum - Deletions - New York

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