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TeleHealth Benefit Program Enrollment

telehealth enrollment

Step 1

Complete the Census Form. List all employees and indicate whether they are participating.

Step 2

Each participating employee completes the Application.

Step 3

Complete the Agreement for List Billing.

 

Return all completed documents to:

The TDA Insurance Agency
6505 Lee Highway
Chattanooga, TN 37421

Fax: 866.791.2806
Email: TDA@assoc-admin.com