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The LATEST Forms NO. 340 (Rev 2021) PROPOSAL FOR INSURANCE ON THE LIFE OF ANOTHER ADULT PERSON (Not be used for insurance on the lives of minors)Color PHOTO OF THE LIFE TO BE ASSUREDDivision: Branch
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Organizations and entities eligible for the 340b program, such as qualifying hospitals, clinics, and health centers, need to visit the 340b eligibility official website to fill out the eligibility form.
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The official website for 340b eligibility is www.340beligibility.gov
Covered entities participating in the 340B Program are required to file their eligibility on the official website.
To fill out the 340b eligibility on the official website, covered entities must create an account, log in, and follow the prompts to provide the required information.
The purpose of the 340b eligibility official website is to ensure that covered entities are eligible to participate in the 340B Program and to maintain accurate and up-to-date information.
Covered entities must report their patient mix, Medicaid utilization rate, and compliance with program requirements on the 340b eligibility official website.
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