Sample Letter for Authorization to Participate in Broward Florida Medical Plan [Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Medical Plan Administrator] [Medical Plan Company] [Address] [City, State, ZIP Code] Subject: Authorization to Participate in Broward Florida Medical Plan Dear [Medical Plan Administrator], I am writing to formally request authorization to participate in the Broward Florida Medical Plan. As a resident of Broward County, Florida, I believe that this plan would be beneficial for me and my family's healthcare needs. I have thoroughly researched the Broward Florida Medical Plan and am impressed by the comprehensive coverage it offers for medical services, including preventive care, hospitalization, prescription medications, and specialist visits. Its network of healthcare providers in Broward County is extensive, ensuring that I can access quality healthcare services conveniently. I understand that by participating in this plan, I will not only receive essential medical care but also benefit from cost-effective solutions, such as negotiated rates with healthcare providers and access to personalized, coordinated care. By joining the Broward Florida Medical Plan, I am confident that my healthcare needs will be efficiently met and that I will have peace of mind knowing that I am fully covered. For your reference, I have included the necessary information below: 1. Full Name: [Your Full Name] 2. Date of Birth: [Your Date of Birth] 3. Address: [Your Address in Broward County, Florida] 4. Social Security Number: [Your Social Security Number] 5. Contact Number: [Your Contact Number] 6. Email Address: [Your Email Address] 7. Number of Dependents: [Number of Dependents covered under the plan] I kindly request your assistance in providing me with the necessary documentation to complete the enrollment process. Additionally, I would appreciate any guidance or forms that need to be completed to ensure a seamless transition into the Broward Florida Medical Plan. Please feel free to contact me at your earliest convenience if there are any further requirements or if you need additional information from my end. I am looking forward to enrolling in the Broward Florida Medical Plan as soon as possible to start benefiting from its exceptional healthcare coverage. Thank you for your attention to this matter. I greatly appreciate your prompt assistance and cooperation. Sincerely, [Your Full Name]
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.