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Plan Use Only: Contract #: Group #: Member ID: Please contact Capital Health Plan if you need information in another language or format (Braille). To Enroll in Capital Health Plan in 2018, Please

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What is plan use only?

Plan use only is a designation used on documents or forms to indicate that certain information provided should not be used for any purpose other than the specific plan or transaction it was intended for.

Who is required to file plan use only?

Anyone who is submitting sensitive information that is designated as plan use only.

How to fill out plan use only?

Fill out the document or form as usual, but clearly mark or designate the sensitive information as 'plan use only'.

What is the purpose of plan use only?

The purpose of plan use only is to protect sensitive information from being used for unauthorized purposes.

What information must be reported on plan use only?

Any information that is deemed sensitive and designated as plan use only.

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