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MASSACHUSETTS NEW CASE SUBMISSION CHECKLIST

MASSACHUSETTS NEW CASE SUBMISSION CHECKLIST 2025

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The document outlines the checklist and application process for small group employers to set up coverage with Tufts Health Plan in Massachusetts. It details required paperwork, including completed applications, enrollment forms, wage statements, and verification of alternative coverage. The document also includes sections for employer information, broker designation, health plan selection, and confirmation of eligibility requirements. Additionally, it provides instructions for new members on how to enroll and access their benefits.

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Click ‘Get Form’ to open the MASSACHUSETTS NEW CASE SUBMISSION CHECKLIST in our editor.
Begin by filling out the 'Small Group Employer Application' section. Ensure that all fields, such as the full legal name of the group and contact information, are completed accurately.
Next, complete the 'Member Enrollment Forms' section. This includes entering personal details for each member, selecting a primary care provider, and indicating any other health coverage.
Proceed to fill out the 'Verification of Alternative Coverage' form if applicable. Clearly state your reasons for waiving coverage and provide necessary details about alternative insurance.
Finally, review all sections for completeness and accuracy before submitting. Use our platform's features to save your progress and ensure you have filled out every required field.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (98 Votes)
2020	4.4 Satisfied (229 Votes)
2015	4.3 Satisfied (225 Votes)
2014	4.1 Satisfied (61 Votes)

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