The Iowa Affidavit of No Coverage by Another Group Health Plan is a legal document that certifies an individual's eligibility for health insurance coverage under a specific group health plan. It serves as proof that the applicant does not have any existing coverage under another group health plan. This affidavit is required by the state of Iowa to ensure that individuals do not receive duplicate benefits from multiple group health plans, preventing fraudulent claims and abuse of the health insurance system. By declaring that they do not have coverage under another group health plan, applicants are affirming their eligibility for enrollment in the specified Iowa group health plan. The Iowa Affidavit of No Coverage by Another Group Health Plan is typically filled out during the enrollment process for a new group health plan or during a special enrollment period. It requires the applicant to provide personal details including their full name, address, date of birth, and social security number. The affidavit may also request information about any previous group health plans the applicant was enrolled in, to ensure there is no overlapping coverage. Keywords: Iowa, Affidavit of No Coverage, group health plan, eligibility, enrollment, duplicate benefits, fraudulent claims, abuse, health insurance system, enrollment process, special enrollment period, personal details, full name, address, date of birth, social security number, previous group health plans, overlapping coverage.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.