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Summary of Benefits and Disclosure Form Small Business Group SALAD HMO Y MS Plan Platinum $10+ INF Plan F3XDear Prospective Health Net member, Thank you for considering Health Net as your health care

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What is exclusions and limitations?

Exclusions and limitations are conditions or constraints specified in a contract or agreement that restrict what is covered or allowed.

Who is required to file exclusions and limitations?

The party responsible for the contract or agreement is required to file exclusions and limitations.

How to fill out exclusions and limitations?

Exclusions and limitations can be filled out by providing details of the conditions or constraints in the designated section of the contract or agreement.

What is the purpose of exclusions and limitations?

The purpose of exclusions and limitations is to clarify what is not covered or allowed under a contract or agreement.

What information must be reported on exclusions and limitations?

The information reported on exclusions and limitations should include the specific conditions or constraints that apply.

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