PUBLIC HEARING REPLY FORM
Persons wishing to present testimony at the public hearing on Regulatory Approval of Health Insurance Premium Rates are
requested to complete this reply form as soon as possible and mail, email or fax it to:
I plan to attend the following public hearing on Regulatory Approval of Health Insurance Premium Rates to be conducted by the
Assembly Committee on Insurance on June 8th.
I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions
which may arise. I will provide 10 copies of my prepared statement.
I will address my remarks to the following subjects:
I would like to be added to the Committee mailing list for notices and reports.
I would like to be removed from the Committee mailing list.
I will require assistance and/or handicapped accessibility information.
Please specify the type of assistance required: