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This document provides important information regarding changes to the Centers Plan for Dual Coverage Care (HMO D-SNP) for the year 2025, including updates to costs, benefits, and network providers. It explains what members should do now to understand how these changes may impact their coverage and provides resources for assistance in reviewing plan options.
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How to fill out annual notice of changes

01
Gather all necessary information, including your current policy details and the changes being made.
02
Carefully read the instructions provided with the annual notice of changes form.
03
Fill in your personal information, such as your name and address, in the designated fields.
04
Clearly indicate the changes to your plan, including any changes to coverage or premiums.
05
Review the notice for accuracy and completeness before submitting it.
06
Submit the completed notice by the specified deadline to ensure processing of the changes.

Who needs annual notice of changes?

01
People enrolled in Medicare health plans who experience changes to their benefits, premiums, or service area.
02
Individuals who want to keep their plan information updated annually.
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The annual notice of changes is a document that notifies clients or stakeholders of any modifications in policies, terms, or conditions from the previous year.
Typically, organizations such as insurance companies, banks, and other financial institutions are required to file the annual notice of changes.
To fill out the annual notice of changes, gather all relevant information, including changes to policies or terms, and use the designated form or template provided by the regulatory authority to ensure all necessary details are included.
The purpose of the annual notice of changes is to keep clients informed about updates and modifications to their agreements, ensuring transparency and compliance with regulatory requirements.
The information that must be reported typically includes changes in premiums, coverage, policy terms, fees, and any other relevant updates that may affect the clients.
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