Miss. Code. tit. 19, pt. 3, ch. 9, app 19-3-9-A
Date
Name
Address
City, State Zip Code
RE: Applicant/Insured's Name
Policy # (if applicable)
Dear __________________ :
We believe that you may qualify for health insurance from the Mississippi Comprehensive Health Insurance Risk Pool Association (the "Association"). This insurance is available to Mississippi residents who, because of health conditions, cannot secure health insurance coverage substantially similar to the Association plan coverage without material underwriting restrictions at a rate equal to or less than the Association plan rate. Other eligibility requirements, exclusions and limitations may apply.
You may apply to the Association for a determination of your eligibility for insurance on application forms available from the Association.
For more information regarding the Association go to www.mississippihealthpool.org or contact the Association at:
Mississippi Comprehensive Health Insurance Risk Pool Association
Post Office Box 13748
Jackson, MS 39236-3748
888-820-9400
Insurance Company Name Address
Contact Person Phone Number
Miss. Code. tit. 19, pt. 3, ch. 9, app 19-3-9-A