COMMONWEALTH OF VIRGINIA DEPARTMENT OF HUMAN RESOURCE MANAGEMENT
Group Administrator Memo
TLC Group Benefits Administrators
Department of Human Resource Management State and Local Health Benefits Programs May 25, 2007
Completion of the Group Health Plan Report for the IRS/SSA/CMS Data Match Project
Following is information to assist you in completing the Data Match Project report if requested by The Centers for Medicare & Medicaid Services (CMS) and will supersede responses provided in our Group Administrator Memo #05-03 dated July 21, 2005. Thank you for your patience as we have worked through the report’s new format.
Part I: Employer Information