Texas Affidavit of No Coverage by Another Group Health Plan

State:
Multi-State
Control #:
US-321EM
Format:
Word; 
Rich Text
Instant download

Description

The employee named in this affidavit attests to the fact that he or she is not covered by any other group health plan. The Texas Affidavit of No Coverage by Another Group Health Plan is a legal document that certifies that an individual does not have coverage under any other group health plan. This affidavit is required when an individual is applying for coverage under a Texas health benefit plan and is claiming that they have no other group health plan coverage. The purpose of this affidavit is to ensure that there is no duplication of benefits, prevent fraudulent claims, and establish the individual's eligibility for coverage. It allows the Texas health benefit plan to determine the primary source of coverage for medical expenses. There are two main types of Texas Affidavit of No Coverage by Another Group Health Plan: 1. Employee or Individual Affidavit: This is completed by an employee or an individual who is applying for coverage under a Texas health benefit plan. They must certify that they do not have coverage under any other group health plan. 2. Dependent Affidavit: This is completed by a dependent who is applying for coverage under a Texas health benefit plan. They must certify that they do not have coverage under any other group health plan as a dependent. Keywords: Texas Affidavit, No Coverage, Another Group Health Plan, legal document, certification, Texas health benefit plan, duplication of benefits, fraudulent claims, eligibility, medical expenses, employee, individual, dependent.

The Texas Affidavit of No Coverage by Another Group Health Plan is a legal document that certifies that an individual does not have coverage under any other group health plan. This affidavit is required when an individual is applying for coverage under a Texas health benefit plan and is claiming that they have no other group health plan coverage. The purpose of this affidavit is to ensure that there is no duplication of benefits, prevent fraudulent claims, and establish the individual's eligibility for coverage. It allows the Texas health benefit plan to determine the primary source of coverage for medical expenses. There are two main types of Texas Affidavit of No Coverage by Another Group Health Plan: 1. Employee or Individual Affidavit: This is completed by an employee or an individual who is applying for coverage under a Texas health benefit plan. They must certify that they do not have coverage under any other group health plan. 2. Dependent Affidavit: This is completed by a dependent who is applying for coverage under a Texas health benefit plan. They must certify that they do not have coverage under any other group health plan as a dependent. Keywords: Texas Affidavit, No Coverage, Another Group Health Plan, legal document, certification, Texas health benefit plan, duplication of benefits, fraudulent claims, eligibility, medical expenses, employee, individual, dependent.

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Texas Affidavit of No Coverage by Another Group Health Plan