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Field 9 d - Insurance Plan Name or Program Name
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 06:52 AM

The “Insurance Plan Name or Program Name” identifies the name of the plan or program of the other insured as indicated in Item Number 9.

INSTRUCTIONS: Enter the other insured’s insurance plan or program name.

MEDICARE - Enter the Coordination of Benefits Agreement (COBA) Medigap-based Identifier (ID). 


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