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Group Hospitalization and Medical Services, Inc. doing business as Headfirst Blue Cross Bluesier (Headfirst) andCareFirst BlueChoice, Inc. (Headfirst BlueChoice) 840 First Street, NE Washington, DC

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How to fill out va-hcr-dental-vision-only-group-contract-application

01

Step 1: Fill out the applicant information section with all required details

02

Step 2: Provide information about the group requesting dental and vision coverage

03

Step 3: Include details about the dental and vision benefits being requested

04

Step 4: Sign and date the application where indicated

05

Step 5: Submit the completed application to the relevant VA-HCR office

Who needs va-hcr-dental-vision-only-group-contract-application?

01

Employers or organizations looking to provide dental and vision coverage for a group of individuals

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What is va-hcr-dental-vision-only-group-contract-application?

The va-hcr-dental-vision-only-group-contract-application is an application for dental and vision only group contracts under the Virginia Health Care Reform.

Who is required to file va-hcr-dental-vision-only-group-contract-application?

Insurance companies and group administrators offering dental and vision only contracts in Virginia are required to file va-hcr-dental-vision-only-group-contract-application.

How to fill out va-hcr-dental-vision-only-group-contract-application?

The va-hcr-dental-vision-only-group-contract-application can be filled out online through the Virginia Health Care Reform website or by submitting a paper application to the designated office.

What is the purpose of va-hcr-dental-vision-only-group-contract-application?

The purpose of va-hcr-dental-vision-only-group-contract-application is to ensure compliance with health care reform regulations and to provide essential dental and vision coverage to eligible individuals.

What information must be reported on va-hcr-dental-vision-only-group-contract-application?

The va-hcr-dental-vision-only-group-contract-application requires detailed information about the insurance company or group administrator, contract terms, coverage details, and pricing.

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