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Medical outofpocket cost reimbursement claim FORM2020 COMA Premium Assistance Program To request reimbursement from the Oregon Health Insurance Marketplace for an allowed in network medical service,
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Who needs form cofa premium assistance?

01
Individuals who qualify for Compact of Free Association (COFA) Premium Assistance program.
02
Individuals who require financial assistance with healthcare premiums.

What is The COFA Premium Assistance Program - State of Oregon Form?

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Form COFA Premium Assistance is a tax form used for reporting premium assistance received for health insurance under the Compact of Free Association.
Individuals who receive premium assistance for health insurance under the Compact of Free Association are required to file form COFA Premium Assistance.
Form COFA Premium Assistance can be filled out by providing details of the premium assistance received and any other related information as required by the form.
The purpose of form COFA Premium Assistance is to report the premium assistance received for health insurance under the Compact of Free Association.
The information that must be reported on form COFA Premium Assistance includes details of the premium assistance received and any other related information as required by the form.
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