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Good News! No Rate Increase for the New Contract Year, Beginning JULY 1, 2011, April 2011 Annual Open Enrollment & Election Form for Dental Insurance Enrolled in our Blue Cross Blue Shield of Illinois
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How to fill out no rate increase for
How to fill out a no rate increase form:
01
Start by obtaining the appropriate form from your insurance provider or employer. These forms are typically available online or can be requested through customer service.
02
Carefully read the instructions and any accompanying documentation to ensure you understand the purpose and requirements of the form.
03
Begin by entering your personal information, such as your name, address, and contact details, in the designated fields.
04
Provide your policy or account number, if applicable, to help the insurance provider identify your specific coverage.
05
Clearly state the reason why you are requesting a no rate increase. This could include financial hardship, stable financial situation, or any other valid reason. Be concise but thorough in explaining your circumstances.
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Attach any supporting documentation that may be necessary, such as recent pay stubs, bank statements, or proof of financial difficulty (if applicable).
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If there are any sections on the form that require additional explanation or details, provide clear and concise responses.
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Double-check all the information you have entered to ensure accuracy and completeness.
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Review any terms, conditions, or clauses mentioned in the form, especially those pertaining to the no rate increase request, to ensure you are in compliance.
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Sign and date the form once you have completed all required sections.
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Make a copy of the filled-out form for your records.
Who needs no rate increase for?
01
Individuals or families who are experiencing financial hardships and cannot afford an increase in insurance premiums.
02
Policyholders who have maintained a stable financial situation and wish to prevent unnecessary rate hikes.
03
Anyone who believes they have valid reasons to request exemption from a rate increase, such as individuals with fixed incomes or unexpected financial burdens.
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