All Government Forms in Washington

12021 - 12040 of 13049 forms

Form Title Agency Jurisdiction
UMP (ArrayRx) Medicare Coverage Determination Request form Health Care Authority, Washington State Washington
UMP (ArrayRx) Medicare Coverage Redetermination Appeal form Health Care Authority, Washington State Washington
UMP (ArrayRx) Multiple prescription drug coverage inquiry form (coordination of benefits [COB]) Health Care Authority, Washington State Washington
UMP (ArrayRx) Prescription Drug Claim Form Health Care Authority, Washington State Washington
UMP (ArrayRx) Prescription drug complaints and appeals form Health Care Authority, Washington State Washington
UMP Classic 2017 Certificate of Coverage (COC Health Care Authority Washington
UMP Classic 2018 Certificate of Coverage (COC Health Care Authority Washington
UMP Classic 2019 Certificate of Coverage (COC Health Care Authority Washington
UMP Classic and UMP Plus: 2019 High-cost generic drugs Health Care Authority Washington
UMP Classic and UMP Plus: Value Tier Drugs Health Care Authority Washington
UMP Classic Medicare with Part D (PDP) (ArrayRx) Electronic Funds Transfer Form Health Care Authority, Washington State Washington
UMP Classic Medicare with Part D (PDP) (ArrayRx) Prescription Drug Claim Form Health Care Authority, Washington State Washington
UMP Consumer-Directed Health Plan (UMP CDHP) 2017 Certificate of Coverage (COC Health Care Authority Washington
UMP Consumer-Directed Health Plan (UMP CDHP) 2018 Certificate of Coverage (COC Health Care Authority Washington
UMP Consumer-Directed Health Plan (UMP CDHP) 2019 Certificate of Coverage (COC Health Care Authority Washington
UMP enrollee notice Health Care Authority Washington
UMP fact sheet on opioids Health Care Authority Washington
UMP nondiscrimination statement and language access notice Health Care Authority Washington
UMP Notice of Privacy Practices effective November 1, 2018 Health Care Authority Washington
UMP Open Enrollment Newsletter 2018 Health Care Authority Washington