I Am Essential Short-term Plan Comments Sign-on

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

I Am Essential Short-term Plan Comments Sign-on

We encourage your organization to sign on to the comment letter to demonstrate the strong level of opposition to the proposed rule and the harm short-term plans would have on the health care market and people living with chronic and serious conditions if finalized.

To sign on to the letter, please fill out this form by 2 pm ET, Monday, April 23, 2018.

Sign in to Google to save your progress. Learn more

* Indicates required question

Name *

Your answer

Title *

Your answer

Organization (can write more than one) *

Your answer

Email address *

Your answer

Are you authorized to sign-on for your organization? *

Yes

No

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy