Justification of Non-material change

Justification of Non-material change.docx

Pre-Existing Condition Insurance Plan (PCIP) HIPAA Authorization Form

Justification of Non-material change

OMB: 0938-1161

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Justification of Non-material Change

(0938-1161)



We are removing the word GEHA and the following comma “GEHA,” from the attached form.  This is the only change that we are making to the form and it is not a substantive change.  This form is being changed because of a recent policy decision with our third party administrator (TPA).  Currently our form identifies GEHA as the name of the PCIP administrator.  We recently made a change to our contract with our TPA  that we would be removing their name from all PCIP related materials effective June 15th.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWILLIAM PARHAM
File Modified0000-00-00
File Created2021-01-29

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