Form DS1962 Request for New Sep Groups - California

Form DS1962 Request for New Sep Groups - California

What Is Form DS1962?

This is a legal form that was released by the California Department of Developmental Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DS1962?A: Form DS1962 is a request form for new SEP (Special Enrollment Period) groups in California.

Q: What is a Special Enrollment Period (SEP)?A: A Special Enrollment Period (SEP) is a period outside of the annual Open Enrollment Period when individuals can enroll in a health insurance plan.

Q: Who is eligible to request new SEP groups using Form DS1962?A: Insurance carriers and plan administrators in California are eligible to request new SEP groups using Form DS1962.

Q: What information is required on Form DS1962?A: Form DS1962 requires information about the insurance carrier or plan administrator, the proposed SEP group(s), and the reason for requesting the new SEP group(s).

Q: Are there any fees associated with submitting Form DS1962?A: No, there are no fees associated with submitting Form DS1962.

Q: What should I do after filling out Form DS1962?A: After filling out Form DS1962, you should submit it to the California Department of Managed Health Care (DMHC) or your insurance carrier or plan administrator, as instructed.

Q: How long does it take to process a request for new SEP groups?A: The processing time for a request for new SEP groups can vary. It is recommended to contact the California Department of Managed Health Care (DMHC) or your insurance carrier or plan administrator for more information.

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Form Details:

  • Released on January 1, 2005;
  • The latest edition provided by the California Department of Developmental Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DS1962 by clicking the link below or browse more documents and templates provided by the California Department of Developmental Services.

Download Form DS1962 Request for New Sep Groups - California

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  • Form DS1962 Request for New Sep Groups - California, Page 1
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