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Land of Lincoln Health Affidavit of Domestic Partnership CERTIFICATION We certify that is the Domestic Partner of (Print domestic partner name) (Print employee name) In accordance with the following
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Land of Lincoln Health is a health insurance company that offers coverage to individuals and families in Illinois.
Individuals and families in Illinois who are seeking health insurance coverage may be required to file with Land of Lincoln Health.
To fill out Land of Lincoln Health, individuals can visit their website or contact their customer service for assistance.
The purpose of Land of Lincoln Health is to provide health insurance coverage to residents of Illinois.
Information such as personal details, income, family size, and healthcare needs may need to be reported on Land of Lincoln Health.
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