Get Please Check The Appropriate Box(es) Below - Opm

Completing the Please Check The Appropriate Box(es) Below - Opm form is an essential process for health plans participating in surveys. This guide will provide clear and supportive instructions to help users navigate the form with ease.

Follow the steps to fill out the form accurately and efficiently.

1. Click the ‘Get Form’ button to obtain the form and open it in your online editor.
2. Begin by filling in the 'Plan Name' section. Ensure that the name of the health plan is clearly stated in the provided space.
3. Next, you need to enter the corresponding 'FEHB Sub-Code' in the designated field. This code is crucial for identifying the specific health plan.
4. In this section, check the appropriate box or boxes that apply to your health plan. Options include participation in various CAHPS® surveys for adults and children, or if your plan has fewer than 500 FEHB subscribers and will not conduct surveys.
5. Provide the name of the NCQA certified survey vendor that will be conducting the survey in the designated area.
6. Fill in the 'Survey Vendor Contact Information' with the name, address, email, and telephone number of the vendor.
7. Enter the contact details for your health plan. This includes the contact person's name, address, email, and telephone number.
8. If applicable, fill out the 'Plan Contact & Address for Invoice' section with the details if it differs from the contact information provided above.
9. Review all filled sections for accuracy. Ensure that all required fields are completed correctly.
10. Once you have filled out the form, you can save changes, download the completed form, print it for physical submission, or share it as needed.

Complete your forms efficiently online to ensure timely submission.