Sage Memorial Plan Documents
Here you’ll find the Sage Memorial Hospital documents and forms you need in Adobe PDF format. Don’t have Adobe Reader? Get it here
Sage Memorial Hospital Health Plan Documents
Summary of Benefits & Coverage (SBC)Download PDF |
SBC GlossaryDownload PDF |
Plan DocumentDownload PDF |
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Helpful Documents and Forms
HIPAA Authorized Representative FormDownload PDF
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Enrollment FormDownload PDF
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Medicare Part D NotificationDownload PDF
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Coordination of Benefits (COB) QuestionnaireDownload PDF |
Explanation of Benefit (EOB) ExampleDownload PDF |