Payment of claims for reimbursement of covered expenses under an individual or family coverage is contingent upon certification by the subscriber of the following:

1. (1) The names, sex, social security numbers, addresses and birthdays of eligible dependents;
2. (2) The name and address of any insurance company or employer with whom a group health insurance policy is carried by the subscriber or dependent and the group number of such policy;
3. (3) Any additional information deemed necessary by the Department for the clarification of information previously provided.

Specific Authority 110.123(5) FS. Law Implemented 110.123 FS. History–New 7-16-86, Formerly 22K-1.217, Amended 8-22-96, Repromulgated 1-31-02.