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Texas Discount Health Care Program Operator Biographical Certificate Form

State:
Texas
Control #:
TX-FIN526
Format:
PDF
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Description

Discount Health Care Program Operator Biographical Certificate Form

The Texas Discount Health Care Program Operator Biographical Certificate Form is a form issued by the Texas Department of Insurance that is required for all operators of the Texas Discount Health Care Program. The form is used to provide the operator's biographical information to the Texas Department of Insurance, who then uses the information to identify and verify the operator's eligibility to manage the state-funded program. The Texas Discount Health Care Program Operator Biographical Certificate Form includes the operator's name, contact information, Social Security Number, and other personal information. Once the form is completed, it must be signed by the operator and submitted to the Texas Department of Insurance for approval. There are two types of Texas Discount Health Care Program Operator Biographical Certificate Forms: one for individuals and one for business entities.

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Texas Discount Health Care Program Operator Biographical Certificate Form