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Washington Application for Group Membership & Authorization for Release of Insurance Data

State:
Washington
Control #:
WA-SKU-3338
Format:
PDF
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Description

Application for Group Membership & Authorization for Release of Insurance Data Washington Application for Group Membership & Authorization for Release of Insurance Data is an online form used by employers in Washington State to provide information about their employees and authorize the release of insurance information. The application is used to facilitate enrollment in group health insurance plans and allow employers to access premium and benefits information. There are two main types of Washington Application for Group Membership & Authorization for Release of Insurance Data: the Group Membership Application and the Authorization for Release of Insurance Data. The Group Membership Application is used to gather information about the employer, employees, and dependents. This includes contact information, Social Security numbers, and date of birth for each employee. The Authorization for Release of Insurance Data allows employers to access benefits and premium information from their insurance provider. Both forms must be completed and submitted to the Washington State Office of the Insurance Commissioner for approval.

Washington Application for Group Membership & Authorization for Release of Insurance Data is an online form used by employers in Washington State to provide information about their employees and authorize the release of insurance information. The application is used to facilitate enrollment in group health insurance plans and allow employers to access premium and benefits information. There are two main types of Washington Application for Group Membership & Authorization for Release of Insurance Data: the Group Membership Application and the Authorization for Release of Insurance Data. The Group Membership Application is used to gather information about the employer, employees, and dependents. This includes contact information, Social Security numbers, and date of birth for each employee. The Authorization for Release of Insurance Data allows employers to access benefits and premium information from their insurance provider. Both forms must be completed and submitted to the Washington State Office of the Insurance Commissioner for approval.

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Washington Application for Group Membership & Authorization for Release of Insurance Data