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New Jersey State Department of Health Health Care for the Uninsured Program NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE FACT SHEET Kim Guadagno
Page 3 December 2017 Fact Sheet #38 Alternate benet Program (AbP) This fact sheet is a summary and not intended to provide all information. Although every attempt at accuracy is made, it cannot be guaranteed. • sign a contract with the employer to participate in
), New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin.
About the Author Mark Zegarelli is the author of Logic For Dummies (Wiley), Basic Math & Pre-Algebra For Dummies (Wiley), and numerous books of puzzles.He holds degrees in both English and math from Rutgers University, and lives in Long Branch, New Jersey, and San Francisco, California.
CLAIM FORM AND INSTRUCTIONS If you have any questions regarding benefits available, or how to file your claim, or if you would like to appeal any determination, please contact our Customer Care Center at
GEF02-1 Page 2 of 4 DEC BENEFICIARY DESIGNATION FOR EMPLOYEE INSURANCE (Dependent Insurance is Payable to the Employee) The Employee signing below names the following person(s) as primary beneficiary(ies) for any MetLife payment upon his or her death.