Get the free PERS Choice Basic Plan Evidence of Coverage January, 2014. PERS Choice Basic Plan Ev...

Basic Plan Preferred Provider Organization Evidence of Coverage Effective January 1, 2014, December 31, 2014, A Self-Funded Plan Administered Under the Public Employees Medical & Hospital Care Act

How to fill out pers choice basic plan

How to fill out pers choice basic plan:

1. Obtain the pers choice basic plan form either through your employer or directly from the insurance provider.
2. Carefully read through the form to understand the information required and any instructions provided.
3. Begin by filling out your personal information, such as your name, date of birth, address, and contact details.
4. Provide accurate details about your current health insurance coverage, including the name of the insurance carrier and policy number, if applicable.
5. Next, indicate the dependents you want to enroll in the pers choice basic plan, if applicable. Include their full names, dates of birth, and any other requested information.
6. If there are any particular medical conditions or health concerns that you or your dependents have, disclose them truthfully in the designated section.
7. Review and double-check all the information filled in the form to ensure its accuracy and completeness.
8. Sign and date the form to certify that the information provided is true and complete to the best of your knowledge.
9. Submit the filled-out pers choice basic plan form to your employer or insurance provider as instructed.

Who needs pers choice basic plan:

1. Individuals who do not have any other health insurance coverage and are looking for a basic plan to meet their healthcare needs.
2. People who are employed by organizations that offer pers choice basic plan as part of their employee benefits package.
3. Individuals who prefer a lower-cost health insurance option with a limited range of benefits compared to comprehensive plans.

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What is pers choice basic plan?

The pers choice basic plan is a health insurance plan offered by Pacific Health Alliance with basic coverage.

Who is required to file pers choice basic plan?

Employers with employees enrolled in pers choice basic plan are required to file the plan.

How to fill out pers choice basic plan?

To fill out the pers choice basic plan, employers need to provide information about their company, employees enrolled in the plan, and the coverage details.

What is the purpose of pers choice basic plan?

The purpose of pers choice basic plan is to provide basic health insurance coverage to employees of eligible companies.

What information must be reported on pers choice basic plan?

Employers need to report employee enrollment details, coverage provided, and premium payments made for the pers choice basic plan.