NL 00701.005 Usage Chart for HI/SMI Form Notices

Situation/Usage Form Notice POMS Section
Acknowledgement of Request for Medical Insurance Termination CMS-L457 NL 00701.117
Acknowledgement of Request for Premium Hospital Insurance Termination CMS-L458 NL 00701.120

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701005
NL 00701.005 - Usage Chart for HI/SMI Form Notices - 01/21/1993
Batch run: 09/17/2012
Rev:01/21/1993