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Exclusive Provider Organization (EPO)
Combined Evidence of Coverage and Disclosure Form
for the Basic Plan
Effective January 1, 2014
Column/Mendocino/Sierra
Contracted by the Callers Board of Administration
Under
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What is basic plan - blue?
Basic Plan - Blue is a health insurance plan offered by XYZ Insurance Company. It is designed to provide basic healthcare coverage to individuals and families.
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Any individual or family who wishes to enroll in Basic Plan - Blue can file for it. However, eligibility criteria and enrollment procedures may vary based on the specific regulations and requirements of XYZ Insurance Company.
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The information required to be reported on Basic Plan - Blue may include personal details (such as name, age, and address), employment information, income details, and any medical conditions or pre-existing conditions.
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