Official SealDepartment of Budget and Management


#19-005224-0004
Supplemental Questionnaire

Last Name
First Name
1

Do you hold a master’s degree in health policy?

Yes No
 

If not, please describe your level of education and/or your professional experience that is equivalent to a master's degree in health policy. In your response, reference the companies and positions that are listed on the application.

2

Please describe your experience working with the Affordable Care Act as it pertains to the individual and small group insurance markets. In your response, reference the companies and positions that are listed on the application. If you do not have this experience, type N/A.

3

Please list your experience working with the following groups. In your response, reference the companies and positions that are listed on the application. If you do not have this experience, type N/A.
• insurance carriers and/or insurance agents,
• chambers of commerce and,
• State and/or Federal legislatures


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