Program 1 Other markets/details for Program 1 repeat for 2-5 Name of Payment 65 words. N/A Reform Program and Name and contact details (email and phone) of contact person who can answer questions about program being described 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 above) Title Contact Person's (As above) (As Email Contact Person's (As above) (As above) 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 above) authorized to update this program entry in
Program 1 Other markets/details for Program 1 repeat for 2-5 Name of Payment Reform Program and Name and contact details (email and phone) of contact person who can answer questions about program being described 65 words. 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 Title (As above) (As above) Contact Person's Email (As above) (As Contact Person's (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 (As above) (As above)
2017-QHP-Certification-Application-DRAFT-1-21-16.docx