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You are Here: Home Page > Health Care Reform Act (HCRA) > Supplemental Regional Covered Lives Assessment, 2008-2009  

Supplemental Regional Covered Lives Assessment, 2008-2009

• Dear Payor/Third Party Administrator: 2008-2009 Supplemental Regional Covered Lives Assessment Rates
• Instructions for Completing Report
  • Example Reporting Form (PDF, 100KB, 3pg.)
• DOH-4454 Supplemental Report Certification Form (PDF, 33KB, 1pg.)
• Schedule of Report and Payment Due Dates
• 2008 Supplemental Rates (PDF, 28KB, 1pg.)
  • All GME Regional Covered Lives Assessment Rates