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Form 1095-C for Hollywood Florida: What You Should Know

The HMO plan, which provides a 750 maximum benefit per year/per person, and 3.) the PPO Plan with Cagney Medical, which provides a 350 maximum benefit per year/per person. Coverage is available at no cost to you, after you sign a  contract with the City of Hollywood. The coverage provided by Cagney Medical is different from what is provided by  other third party plans. Cagney Medical offers a unique coverage package that will save you more than 2,000 per year, which you  can use as a bonus toward your annual premium payments on your health insurance plan. Call the City of Hollywood at  or complete an online request to get the City of Hollywood dental plan information that you require. If you are interested in becoming a member of a Cagney Dental plan, call and provide the following information: Full name Date of Birth (the date on the birth certificate of the patient's child). Current address of patient. birthplace, city and state (city or town of residence) Full medical information: Date and time of birth (Day or night) Medical information (if applicable): Patient's last known or previous medical condition. Date of hospitalization or admission (date and time of hospitalization or admission) Current treatment plan for medical condition currently under treatment (if treatment is currently under treatment) What is included in the Basic Plan (includes vision, dental, life & disability insurance)? Basic Plan includes: No co-payments. Coinsurance: Covers in case of an accidental or foreseeable loss or payment. This insurance coverage is required by law to be in effect, by law if you are a California resident, and you are providing or accepting any form of benefits. No deductibles. No annual premiums: None. Coverage only slightly higher in the first year: 3,900-33,350, depending on geographic area of service, service level, and  other criteria that are developed by Cagney Medical. Basic plan limits: No annual deductible Exact amount of premium to pay: No premium is due until you have provided at least 12 months of coverage. Expiry of agreement: One year from date of commencement of coverage.

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