health insurance issuer / certain contraceptive services / contraceptive services / /
Organization
office of Policy and Research / Medicaid Services Center for Consumer Information & Insurance Oversight / U.S. Department of Labor / Other / Employee Benefits Security Administration / Eligible / Medicare / / /
Position
Secretary of Health / authorized representative / administrator / /
INSTRUCTIONS FOR MODEL NOTICE (OMB Control Number[removed]This model notice may, but is not required to, be used by an eligible organization to provide notice to the Secretary of Health and Human Services (HHS) that