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Disenrollment Forms

How you disenroll depends on which health plan option you're using. Please select your plan from the list below:

If you would like to request reconsideration of involuntary disenrollment, late initial enrollment, or late change to coverage, submit a Reconsideration Request for your region and plan.

If enrolled in the US Family Health Plan, please call 1-800-748-7347 for assistance.

Last Updated 2/28/2014