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H0166.2 ___HOUSE BILL 1005 ___State of Washington65th Legislature 2017 Regular SessionBy Representatives Taylor, Orcutt, Shea, J. Walsh, Haler, Condotta, Young, McCaslin, Griffey, Van Werven, Dent,
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How to fill out h-0166 template

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How to fill out h-0166

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To fill out h-0166, follow these steps:
02
Start by entering your personal information, such as your name, address, and contact details.
03
Provide the necessary details about your current health insurance coverage, including the name of the insurance company and your policy number.
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Indicate whether the person for whom you are completing the form is the policyholder or the dependent.
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If the person is a dependent, provide the policyholder's information, including their name and policy number.
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Answer all the questions regarding the person's eligibility for Medi-Cal or other assistance programs.
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If applicable, provide information about other health insurance plans the person may have.
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Review the completed form to ensure all the information is accurate and complete.
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Sign and date the form before submitting it as instructed.

Who needs h-0166?

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h-0166 is needed by individuals who are applying for or renewing their Medi-Cal coverage or other assistance programs. It is also required for dependents who need to supplement their parent's health insurance information.

What is H-0166 Form?

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H-0166 template instructions

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h-0166 is a specific form used for reporting certain financial information required by regulatory authorities.
Individuals or entities that meet specific financial thresholds or regulatory requirements must file h-0166.
To fill out h-0166, follow the instructions provided for the form, ensuring all relevant information is accurately inputted and any necessary supporting documents are attached.
The purpose of h-0166 is to collect financial data necessary for compliance with regulatory frameworks and to ensure transparency in financial reporting.
h-0166 generally requires reporting on financial statements, income details, and any relevant compliance information specific to the reporting entity.
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