Maryland Insurance Administration / Health Education and Advocacy Unit / Maryland Office / Call Center / Service of the Maryland Health Benefit Exchange AUTHORIZED REPRESENTATIVE FORM / Department of Health / office of Administrative Hearings / Internal Revenue Service / /
OFFICE OF THE ATTORNEY GENERAL, CONSUMER PROTECTION DIVISION HEALTH EDUCATION AND ADVOCACY UNIT COMPLAINT FORM Request for Assistance with an Appeal of Maryland Health Connection Denial This form is to be used by any pe