We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. Premera Blue Cross FEP.Note: The application of the overpayment is not required. In the event that you have received overpayment, please return the funds to Cigna HealthcareSM at: Cigna Healthcare P O Box 188012 Complete the Redetermination Request Form in its entirety. 2018 Tax Overpayment applied to the First Quarter Prepayment - Record the amount of the 2018 Tax Overpayment, Line 12, applied to 2019 First Quarter Prepayment. Please download the form, complete each field and print. Include the form with your refund so we can properly apply the refund and record the receipt.

Overpayment Letter To Insurance Company In Los Angeles

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