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KERN LEGACY HEALTH PLAN Employee & Retiree Medical Plan Options1115 Trust Ave, 1st Floor Bakersfield CA 93301 pH: 661 8683280 Fax: 661 8683295 www.kernlegacyhp.comMember Request for Medical Reimbursement

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How to fill out kern legacy health plan

01

To fill out the Kern Legacy Health Plan, follow these steps:

02

Start by downloading the Kern Legacy Health Plan form from the official website or request a hard copy from the appropriate healthcare provider.

03

Read the instructions and requirements carefully to understand the information you need to provide.

04

Begin by filling in your personal details such as your full name, address, contact information, and date of birth.

05

Move on to the section where you need to provide your medical history. Answer all the questions honestly and accurately, including any pre-existing conditions or previous treatments.

06

If you have any dependents, provide their information in the designated section.

07

Next, fill in your preferred healthcare provider or select from the options provided.

08

Review the completed form to ensure all the information is correct and complete.

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Sign and date the form in the designated area to validate it.

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Submit the filled-out Kern Legacy Health Plan form to the relevant healthcare provider either by mail or in person.

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Keep a copy of the filled-out form for your records.

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Remember to consult the specific instructions or contact the healthcare provider for any additional guidance.

Who needs kern legacy health plan?

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The Kern Legacy Health Plan is designed for individuals who:

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- Are residents of Kern County, California

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- Are in need of affordable healthcare coverage

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- Do not have access to employer-sponsored health insurance

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- Do not qualify for government-funded health programs like Medicaid or Medicare

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- Are not eligible for health insurance through other means

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It is recommended to check the eligibility criteria and requirements of the Kern Legacy Health Plan to determine if it suits your specific needs and circumstances.

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What is Kern Legacy Health Plan?

Kern Legacy Health Plan is a comprehensive health insurance plan offered by Kern County for its employees and their dependents.

Who is required to file Kern Legacy Health Plan?

All eligible employees of Kern County are required to enroll in Kern Legacy Health Plan.

How to fill out Kern Legacy Health Plan?

Employees can fill out Kern Legacy Health Plan by completing the enrollment forms provided by Kern County during the open enrollment period.

What is the purpose of Kern Legacy Health Plan?

The purpose of Kern Legacy Health Plan is to provide affordable and quality health insurance coverage for employees and their dependents.

What information must be reported on Kern Legacy Health Plan?

Employees must report their personal information, dependent information, and selected insurance options on Kern Legacy Health Plan.

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