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“FO S:R 'FC: (:t, (. J DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Region 10 2201 Sixth Avenue. MS/RX 43 Seattle, Washington 98121 DEC '6 20 Douglas Porter, Director
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Ampquot - HCA WA refers to the Health Coverage Assistance Workbook in Washington state.
Employers in Washington state who provide health coverage assistance to their employees are required to file the Ampquot - HCA WA forms.
Employers can fill out the Ampquot - HCA WA forms online through the Washington Health Benefit Exchange website.
The purpose of Ampquot - HCA WA is to report health coverage assistance provided to employees in Washington state.
Employers must report information on the health coverage assistance provided to employees, including the type of coverage and the amount of assistance.
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