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Missouri Consolidated Health Care Palanquin Tobacco PromiseSubmit this form Online: Upload through matchup Fax: 8663468785 Mail: PO Box 104355 Jefferson City, MO 651104355ST TFA Revised 10/2022Please
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Obtain a copy of the Missouri Consolidated Health Care Application form.
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Fill out the applicant information section including your name, address, contact details, and any other required personal information.
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Provide information on your household members, including their names, ages, and relationships to you.
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Complete the income section by documenting all sources of household income, including wages, benefits, and any other sources of financial support.
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Provide information on any existing health insurance coverage.
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Missouri Consolidated Health Care is a program designed to provide comprehensive health care coverage to residents of Missouri.
Employers in Missouri with 50 or more employees are required to file Missouri Consolidated Health Care.
Missouri Consolidated Health Care can be filled out online through the Missouri Department of Revenue website.
The purpose of Missouri Consolidated Health Care is to ensure that all residents have access to affordable and quality health care coverage.
Information such as employee names, social security numbers, wages, and health care coverage details must be reported on Missouri Consolidated Health Care.
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