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State of CaliforniaHealth and Human Service Agency California Department of Public HealthNOTICEEFFECTIVE DATE OF PROVIDER AGREEMENT This notice is to inform you of the regulations that govern the
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State of California Health and refers to the annual health coverage reporting required by the state of California.
Individuals and businesses who provide health coverage to California residents are required to file State of California Health and forms.
State of California Health and forms can be filled out electronically through the Covered California website or manually by submitting paper forms.
The purpose of State of California Health and is to ensure that all residents have access to affordable health coverage and to track compliance with healthcare laws.
Information such as names, addresses, social security numbers, and details of health coverage provided must be reported on State of California Health and forms.
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