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EMPLOYEE BENEFITS DIVISIONNYSHIP Health Insurance Transaction Form for Participating Agencies (PAs)PS503 (6/2024)INSTRUCTIONS: READ AND COMPLETE BOTH PAGES. PLEASE PRINT, CHECK THE APPROPRIATE CHOICES

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How to fill out for participating agencies pas

01

Obtain the necessary forms from the participating agency.

02

Fill out all required information accurately.

03

Be sure to provide any supporting documentation as requested.

04

Submit the completed form to the designated contact at the agency.

Who needs for participating agencies pas?

01

Participating agencies in the program who require individuals to fill out the PAS form.

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What is for participating agencies pas?

Participating Agencies PAS stands for Participating Agencies Payment Accuracy Score.

Who is required to file for participating agencies pas?

Participating agencies that receive federal funds are required to file for Participating Agencies PAS.

How to fill out for participating agencies pas?

To fill out Participating Agencies PAS, agencies must provide accurate information on their financial transactions with federal funds.

What is the purpose of for participating agencies pas?

The purpose of Participating Agencies PAS is to ensure accuracy and accountability in the use of federal funds by participating agencies.

What information must be reported on for participating agencies pas?

Participating Agencies PAS requires reporting of financial transactions and expenditures related to federal funds.

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