Alabama Administrative Code
Title 800 - RETIREMENT SYSTEMS OF ALABAMA
Chapter 800-6-7 - FORMS
Section 800-6-7-.01 - PEH 101-11-83 - PEEHIP Member Record Form

Universal Citation: AL Admin Code R 800-6-7-.01
Current through Register Vol. 42, No. 5, February 29, 2024

Multi-purpose form used to establish insurance coverage, make changes in such coverage, and for cancellation of such coverage.

Author: William T. Stephens, General Counsel, RSA.

Statutory Authority: Code of Ala. 1975, § 41-22-4.

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