Connecticut Application Service Provider Agreement

State:
Multi-State
Control #:
US-CP1027-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Application Service Provider Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

DSS Client Information Line & Benefit Center /ConneCT 1-855-626-6632 .connect.ct.gov Monday ? Friday a.m. to 4 p.m.

Providers may contact the Provider Assistance Center at 1-800-842-8440. An alternate TTY/TDD line is also available at 1-866-604-3470.

CONNECTICUT MEDICAID ASSISTANCE PROGRAM (CMAP)

Who is eligible for Connecticut Medicaid? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows

Connecticut State Office of the Healthcare Advocate Medicaid provides health coverage for some low-income people who cannot afford it. The Medicaid programs in Connecticut are HUSKY A, HUSKY C and HUSKY D. Individuals may meet Medicaid eligibility requirements in a number of ways.

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Connecticut Application Service Provider Agreement