Form HBEX411C Notification of Deceased by an Estate Representative - California

What Is Form HBEX411C?

This is a legal form that was released by the Covered California - 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 Form HBEX411C?
A: Form HBEX411C is a notification form for the deceased by an estate representative in California.

Q: Who can complete Form HBEX411C?
A: The form is completed by the estate representative of the deceased.

Q: What is the purpose of Form HBEX411C?
A: The purpose of Form HBEX411C is to notify the state of California about the death of an individual.

Q: What information is required on Form HBEX411C?
A: Form HBEX411C requires information such as the name and contact information of the estate representative, the date of death, and the deceased individual's information.

Q: Is there a deadline for submitting Form HBEX411C?
A: Yes, Form HBEX411C must be submitted within a certain timeframe after the death of the individual, typically within 90 days.

Q: What happens after submitting Form HBEX411C?
A: After submitting Form HBEX411C, the state of California will update their records and take appropriate actions regarding the deceased individual's benefits and coverage.

Q: Are there any fees associated with filing Form HBEX411C?
A: No, there are no fees associated with filing Form HBEX411C.

Q: What should I do if I have additional questions about Form HBEX411C?
A: If you have additional questions about Form HBEX411C, you can contact the California Health Benefit Exchange or consult with a legal professional.