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Office Use Only Name of staff member/agent/broker (if assisted in enrollment): Rep ID: Plan ID: Effective Date of Coverage: ICE/IEP OEP AEP SEP (type): 18772268500 or TTY 711 7 days a week from 8:00

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What is centerlight healthcare direct complete?

Centerlight Healthcare Direct Complete is a form used to report healthcare coverage information to the IRS.

Who is required to file centerlight healthcare direct complete?

Health insurance providers are required to file centerlight healthcare direct complete.

How to fill out centerlight healthcare direct complete?

Centerlight Healthcare Direct Complete can be filled out electronically or manually by providing the required healthcare coverage information.

What is the purpose of centerlight healthcare direct complete?

The purpose of centerlight healthcare direct complete is to report healthcare coverage information to the IRS.

What information must be reported on centerlight healthcare direct complete?

Centerlight Healthcare Direct Complete requires reporting of individual healthcare coverage information such as policy number, coverage period, and covered individuals.

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