Summary:
The state medical insurance form shall include, but not be limited to (1) the parents' names, addresses, and social security numbers, (2) the name and address of each parent's place of employment (3) the name or names, addresses, policy number or numbers, and coverage type of the medical insurance policies of the parents, (4) CalWORKS case number, Title IV-E foster care case number or Medi-Cal case numbers of the parents and children covered by the insurance policies.