Your claim should include a bill or receipt showing the type of insurance, the name of the provider, your full name and/or your spouse or covered dependent, the month(s) covered, the amount of the premium, and proof of payment.
Your claim should include a bill or receipt showing the type of insurance, the name of the provider, your full name and/or your spouse or covered dependent, the month(s) covered, the amount of the premium, and proof of payment.