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Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services (Spanish translation)
ICR 202412-0938-010 · OMB 0938-1146 · Object 150953301.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services (Spanish translation) |
| Subject | Provides a fillable Summary of Benefits and Coverage template to provide answers to key questions and information about common m |
| Author | CMS |
| File Created | 2025-01-16 |
| Conversion State | partial |