Download:
pdf |
pdfNotice of Intent to Provide Dental Coverage in the Exchange
Issuer Name:
Please lists the State or States in which the
issuer intendeds to offer coverage in an
Exchange as a stand-alone dental plan:
Please complete the following information for each State in which the issuer intendeds to offer dental coverage.
State:
Individual Market Intended Participation:
Small Group Market Intended Participation:
Individual Market Intended Service Area:
Small Group Market Indended Service Area:
| File Type | application/pdf |
| File Title | Draft Dental Plan Notice of Intent Template |
| Author | CMS |
| File Modified | 2012-07-29 |
| File Created | 2012-05-21 |