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2019 / 2020 WELLNESS/PREVENTIVE CARE EXAMINATION ATTESTATION From A cash wellness incentive equivalent to 2.5% of your medical and prescription premiums will be available to you if you have completed

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What is wellness exam attestation form?

Wellness exam attestation form is a document used to confirm that an individual has undergone a wellness exam as required.

Who is required to file wellness exam attestation form?

Individuals who are covered under a specific health plan that mandates wellness exams are required to file the wellness exam attestation form.

How to fill out wellness exam attestation form?

To fill out the wellness exam attestation form, you need to provide your personal information, details of the wellness exam, and any other required information as per the form instructions.

What is the purpose of wellness exam attestation form?

The purpose of the wellness exam attestation form is to ensure that individuals are meeting the wellness exam requirements set by their health plan.

What information must be reported on wellness exam attestation form?

The wellness exam attestation form may require information such as date of the exam, healthcare provider details, test results, and any other relevant details related to the wellness exam.

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