Frequently Asked Questions

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FAQ

What information should I have before completing my Initial Enrollment Questionnaire (IEQ)?

Before completing your IEQ, you should have the following information available:
Your insurance card, for insurance company and prescription drug information; Your employer's name and address (if you receive group health plan coverage through your employer);
Your spouse's Social Security number, employer's name and address, and the group health plan information (if you receive group health plan coverage through your spouse's employer);
Your family member's Social Security number, employer's name and address, and the group health plan information (if you receive group health plan coverage through your family member's employer) The associated insurance  carrier information, employer name and attorney information, if you are receiving benefits or treatment for one of the following conditions:
- Black Lung benefits

- Workers' Compensation benefits

- Injury or illness for which another person could be held responsible

- Injury or illness covered under no fault, automobile or liability insurance



Keywords: Initial Enrollment Questionnaire (IEQ)
(FAQ5509)

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