Form preview

Get the free 2004 Federal Employees Health Benefits Program Plan Brochure - PacifiCare of Califor...

Get Form
This brochure describes the benefits and coverage provided by PacifiCare of California under the Federal Employees Health Benefits (FEHB) Program for 2004, including information on copayments, services,
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign 2004 federal employees health

Edit
Edit your 2004 federal employees health form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your 2004 federal employees health form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit 2004 federal employees health online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to take advantage of the professional PDF editor:
1
Log in to your account. Click on Start Free Trial and sign up a profile if you don't have one.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit 2004 federal employees health. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out 2004 federal employees health

Illustration

How to fill out 2004 Federal Employees Health Benefits Program Plan Brochure - PacifiCare of California

01
Obtain a copy of the 2004 Federal Employees Health Benefits Program Plan Brochure - PacifiCare of California.
02
Review the introduction section to understand the benefits and coverage options.
03
Fill out personal information including name, address, and employee information in the designated sections.
04
Select your desired health plan option by checking the appropriate box.
05
Review the premium costs and make note of your bi-weekly or monthly contributions.
06
Include any dependent information if applicable, ensuring all necessary documentation is attached.
07
Complete the signature section to validate the application.
08
Submit the form by the specified deadline to ensure coverage.

Who needs 2004 Federal Employees Health Benefits Program Plan Brochure - PacifiCare of California?

01
Federal employees who are eligible for health benefits.
02
Individuals seeking health insurance under the Federal Employees Health Benefits Program.
03
Dependents of federal employees looking to enroll in the health plan.
04
Employees wanting to compare different health plans offered for the year.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.7
Satisfied
29 Votes

People Also Ask about

Federal Employee Health Benefits (FEHB) Program During an emergency, do not worry about your FEHB health benefits. Your benefits will continue regardless of the severity of the crisis.
In general, TRICARE is a better choice than any FEHB plan, because its benefits are somewhat better and the premium costs far lower under all TRICARE options.
The Governmentwide Service Benefit Plan (also referred to as the Federal Employee Program or FEP), is administered by the Blue Cross and Blue Shield Association on behalf of Blue Cross and Blue Shield Plans nationwide, and is open to everyone eligible to enroll under the FEHB Program.
PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products.
Medi-Cal—California's Medicaid program—is a state-federal program that offers free or low-cost health coverage to Californians with low family incomes.
FEP Blue Basic With no deductibles and set copays for most services, it's been the most popular choice in the FEHB for over 15 years.
Federal Employee Health Benefits (FEHB) Program StatePlan Name Nationwide GEHA High Deductible Health Plan 800-821-6136 Nationwide MHBP - Consumer Option 800-694-9901 Nationwide MHBP - Std 800-410-7778 Nationwide MHBP - Value Plan 800-410-777823 more rows

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The 2004 Federal Employees Health Benefits Program Plan Brochure - PacifiCare of California is a document that outlines the health benefits, services, and coverage options available to federal employees enrolled in the PacifiCare health plan for that year.
Federal employees and their eligible dependents who wish to enroll in or are already participating in the PacifiCare of California health plan are required to file this brochure as part of their health benefits enrollment.
To fill out the 2004 Federal Employees Health Benefits Program Plan Brochure, individuals must read the instructions provided in the brochure, complete all required personal information, select their preferred coverage options, and submit the form according to the details specified in the document.
The purpose of the brochure is to inform federal employees about the healthcare coverage options provided by PacifiCare, detailing benefits, costs, and guidelines necessary for enrollment and use of services.
The information that must be reported includes personal identification details, dependent information, selected coverage options, demographics, and any relevant health history as applicable for enrollment in the health plan.
Fill out your 2004 federal employees health online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.