Letter of Creditable Coverage Template

Letter of Creditable Coverage Template

What Is a Letter of Creditable Coverage?

A Letter of Creditable Coverage is a document that an individual can use to prove that their insurance policy has ended. The purpose of the document is to confirm information about the individual's previous insurance coverage, its beginning date, and its expiration date. The letter is prepared by the individual's prior insurance carrier and is supposed to be used by those individuals who would like to change their health insurance provider and avoid having a gap in medical insurance.

Alternate Names:

  • Notice of Creditable Coverage;
  • Certificate of Creditable Coverage;
  • COCC.

A printable Letter of Creditable Coverage template can be found through the link below.


How Do I Get a Letter of Creditable Coverage?

If an individual would like to obtain a Creditable Coverage Letter, they can request their insurance company for one. Usually, the letter includes several parts, including:

  1. Date. The document should include the date when it was prepared. It will show that its content is current and valid.
  2. Information About the Insurance Company. In the first part of the document, the sender should designate the identifying information of the insurance company that has provided the health coverage for the policyholder. It can include the name of the company and its location.
  3. Information About the Policyholder. Here the sender can state the personal information of the policyholder, such as their full name and their address. If there are any other participants or dependents to whom the policy applies they should be indicated here as well.
  4. Insurance Policy Details. Senders can use this part of the letter to state the details of the policy by indicating the policy number, name of the health plan, date when the policy begins, date when the policy ends, etc.
  5. Contact Details. In case the receiver of the letter will have any questions concerning the subject, the sender can designate in the letter their contact information. It can contain their email address, fax, and telephone number.

Check out these related letter templates:

Download Letter of Creditable Coverage Template

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  • Letter of Creditable Coverage Template


  • Letter of Creditable Coverage Template, Page 2


  • Letter of Creditable Coverage Template
  • Letter of Creditable Coverage Template, Page 2
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