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MEBA Medical Plan Designation of Authorized Representative

MEBA Medical Plan Designation of Authorized Representative 2025

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The document outlines the process for designating an authorized representative to act on behalf of a participant in the MEBA Medical and Benefits Plan for claims and appeals. It includes instructions for completing a form to appoint a representative, as well as a requirement to complete a Designation of Health Information Recipient form to allow the release of protected health information. The document specifies the necessary information needed from both the participant and the representative, and explains that this designation remains effective until the conclusion of the claims process.

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