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Get Form 3172a - Standard Provisions For Dental And ... - State Of Oregon - Cbs State Or
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How to use or fill out the Form 3172a - Standard Provisions For Dental And ... - State Of Oregon - Cbs State Or online
The Form 3172a serves as a critical document for filing dental and vision group or individual policies in Oregon. This guide provides clear and concise instructions to help users fill out the form accurately and efficiently, ensuring compliance with state regulations.
Follow the steps to fill out the form effectively.
- Click ‘Get Form’ button to obtain the form and open it in the editing platform.
- Enter the insurer name in the designated field at the top of the form.
- Select the type of insurance (TOI) from the options provided: H10I for individual health dental, H10G for group health dental, H20I for individual health vision, or H20G for group health vision.
- Fill in the date of filing in the specified format.
- Indicate the marketing type by selecting either 'Small Group,' 'Large Group,' or 'Stand Alone.'
- Complete the section detailing the base policy by choosing the appropriate option: 'Health Benefit Plan' or 'Health Insurance Policy.'
- If a dental or vision rider is attached to a base policy, proceed to the 'Policy Provisions' section and complete each required item.
- Carefully review all completed sections to ensure that no fields are left blank, as missing information could result in an incomplete filing.
- After confirming the accuracy of your entries, save your changes, and prepare to download, print, or share the completed form as required.
Get started on completing your Form 3172a online to ensure compliance and facilitate your filing process.
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