Program 1 Other markets/details for Program 1 Repeat for 2-5 Name of Payment 65 N/A Reform Program Contact Name for 5 words. N/A Payment Reform Program (person who can answer questions about the program being described) Contact Person's (As above) (As Contact Person's (As (As above) Email Contact Person's (As above) (As above) Phone Contact Name for (As above) (As above) person who is authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact name for the payment reform program, please his/her name) Email for person (As above) (As authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact email for the payment reform
Program 1 Other markets/details for Program 1 Repeat for 2-5 Name of Payment Reform Program 65 N/A Contact Name for Payment Reform Program (person who can answer questions about the program being described) 5 words. N/A Contact Person's (As above) (As Contact Person's Email (As (As above) Contact Person's Phone (As above) (As above) Contact Name for person who is authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact name for the payment reform program, please his/her name) (As above) (As above) Email for person authorized to update this program entry in ProposalTech after Health plan has submitted response (if same as contact email for the payment reform (As above) (As
2017-QHP-Certification-Application-DRAFT-1-21-16.docx