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Healthcare reform in the United States / Presidency of Lyndon B. Johnson / Government / United States / Healthcare in Canada / LifeWise Health Plan of Oregon / Health Insurance Portability and Accountability Act / Consolidated Omnibus Budget Reconciliation Act / Medicaid / Health / Taxation in the United States / Federal assistance in the United States


Washington Individual Enrollment Application Effective January 1, 2015 This application is for health care coverage purchased directly from LifeWise Health Plan of Washington (LifeWise). If you wish to purchase coverage
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Document Date: 2015-03-26 12:03:22

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File Size: 212,42 KB

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City

Subscriber / /

Company

LifeWise Adult Health Plan / Notes Bank Routing / ZIP Checking Bank Routing / /

Country

United States / /

Currency

USD / TTD / /

Event

Product Issues / Product Recall / /

/

IndustryTerm

tobacco product / insurance coverage / healthcare coverage / automatic bank withdrawal / bank account / bank / bank transfer / insurance / insurance benefits / chemical dependency / life insurance / prior / health plan carrier / /

MusicGroup

Yes / /

Organization

Social Security Administration / Name Producer Name LifeWise Producer Number Producer Address Producer Telephone Number / Bank Name Financial Institution / Washington PO / UN Court / FDIC / Financial Institution / Medicare / /

Person

Washington Individual / Legal Guardian / Letter / /

/

Position

benefits administrator / Attorney / benefits manager / administrator / physician / authorized representative / PRODUCER / /

Product

bank / month’s automatic / /

ProvinceOrState

Alaska / Oregon / Washington / /

Technology

pdf / /

URL

lifewisewa.com / www.wahbexchange.org / /

SocialTag