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MUNICIPAL HEALTH BENEFIT PROGRAM
P.O. BOX 188
NORTH LITTLE ROCK, AR 72115
(501) 9786137
FAX (501) 5377265CHANGE OF ADDRESS
Name of Group/Employer:Group Cumbersome of Member / EmployeeSSNOld Mailing
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How to fill out municipal health benefit fund
How to fill out municipal health benefit fund
01
Obtain the necessary forms from the municipal health benefit fund office.
02
Fill out the forms completely and accurately, providing all required information.
03
Attach any necessary supporting documents, such as proof of income or proof of residency.
04
Submit the completed forms and documents to the municipal health benefit fund office either in person or by mail.
05
Follow up with the office to ensure that your application is processed in a timely manner.
Who needs municipal health benefit fund?
01
People who are residents of the municipality and are in need of financial assistance for health-related expenses.
02
Individuals who do not have health insurance or cannot afford the cost of medical care on their own.
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What is municipal health benefit fund?
The municipal health benefit fund is a fund established by a municipality to provide health benefits for its employees.
Who is required to file municipal health benefit fund?
Employers who offer health benefits to their employees through a municipal health benefit fund are required to file.
How to fill out municipal health benefit fund?
Employers can fill out the municipal health benefit fund form provided by the municipality, including information on employee contributions, coverage options, and benefits provided.
What is the purpose of municipal health benefit fund?
The purpose of the municipal health benefit fund is to ensure that employees have access to health benefits through their municipality.
What information must be reported on municipal health benefit fund?
Information that must be reported on the municipal health benefit fund includes employee names, contributions, coverage options, and benefits provided.
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