Health Care Authority, Washington State Forms and Office Locations – Government Agency in Washington

21 - 40 of 135 forms

Form Title	Topics
Claim Information Sheet
Compression garments authorization form
Continuation Coverage Election Notice
Continuation Coverage Election Notice
Declaration of Tax Status form
Decoding 2015-19 Forms 1095-C
Decoding 2020-24 Forms 1095-C
Decoding Form 1095-C 2019
Drug Price Transparency: reporting entity registration form
DSH application troubleshooting
Dual enrollment Q&A for BAs
Electronic Debit Service (EDS) Agreement
Empathy services for beneficiaries
Employee Authorization for Payroll Deduction for HSA
Employee Authorization for Payroll Deduction for HSA
Employee Enrollment/Change form
Employee Enrollment/Change form - medical only
Employee Enrollment Guide
Employee Request for Review/Notice of Appeal form
Employee Request for Review/Notice of Appeal form

Health Care Authority, Washington State