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  • Coventry One Member Designated Representative Form

Get Coventry One Member Designated Representative Form

Our completion of the attached Member Designated Representative Form permits a Coventry Health Care plan* to provide your personal health information to the person(s) you name on the form. For instance, you may want to designate your spouse, your broker, a family member or a friend to assist you with your health care benefits. This form does not permit the Coventry Health Care plan to release information to anyone except the individual or entity you name on the attached form. Coventry will NOT r.

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SUBSIDIARIES Related content

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Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health and Life Insurance Company and their affiliates (Aetna).

In the merger, First Health will merge with and into Coventry Merger Sub Inc., which is a Delaware corporation and wholly owned subsidiary of Coventry. Merger Sub will continue after the merger as the surviving entity and a wholly owned subsidiary of Coventry.

An appointed representative is a person who can act on your behalf to request an appeal or complaint. If you need someone to file a grievance, coverage determination, organization determination, or an appeal on your behalf, you can name a relative, friend, advocate, or anyone else as your appointed representative.

BETHESDA, Md. -Coventry Health Care Inc. will purchase First Health Group Corp. in a $1.8 billion deal in an effort to become a national player in the managed care market.

An authorized representative is the person you choose to help with or handle affairs related to your health care services. This can be a Power of Attorney, a family member, friend, caregiver or an advocate. Your authorized representative would help you with an exception, appeal, or grievance.

We represented Coventry Health Care, Inc. in the sale of its fee-based Medicaid services subsidiary, First Health Services Corporation, to Magellan Health Services, Inc. (NASDAQ: MGLN) for $110 million.

In May 2013, the company was acquired by Aetna for $5.7 billion.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232