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ADMINISTRATIVE SERVICES AGREEMENT (the Agreement)betweenness ASSOCIATION OF COUNTIES HEALTH AND EMPLOYEE BENEFITS POOL (HELP)animal COUNTY (Plan Administrator)Group Number: 39898 Effective Date: October
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How to fill out plan management agreement

01
Obtain a copy of the plan management agreement form from the relevant organization.
02
Read through the form carefully and make sure you understand all the terms and conditions.
03
Fill in your personal details, including your name, address, contact information, and any other required information.
04
Review the services being offered and check off any that you wish to receive.
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Sign and date the agreement form, and make sure to keep a copy for your records.

Who needs plan management agreement?

01
Individuals who are receiving funding or support through a plan management organization.
02
Anyone who wants to outline the services they will receive and the terms of their agreement with the organization.
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A plan management agreement is a legal document that outlines the terms and conditions between a plan manager and a participant for managing services and supports under a funding arrangement.
The plan manager and the participant are required to file the plan management agreement.
Fill out the plan management agreement by providing accurate and complete information about the services and supports being managed, as well as the terms and conditions agreed upon by the plan manager and participant.
The purpose of the plan management agreement is to establish a clear understanding between the plan manager and the participant regarding the management of services and supports under a funding arrangement.
The plan management agreement must include information about the services and supports being managed, the terms and conditions agreed upon, as well as any other relevant information.
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