When terminating your third-party health insurance, you can use this TPHI Termination Letter to inform your insurance company and effect the termination.
[Sender’s Name]
[City, State and Zip Code]
[Date]
[Insurance Company’s Name]
The Health Insurance Department
[City, State and Zip Code]
[Mobile/Fax Number]
Ref: Third-Party Health Insurance Termination Letter
To Whom It May Concern,
This informs you that I will be terminating my third-party health insurance effectively from [Date]. I have the policy number [#] and took out this insurance on [Date].
The reason for termination is [Give Reasons]. I believe this is the right action to take under these circumstances.
Please confirm receipt and contract termination in writing on or before [Date]. Remove all my information from your system to this effect. Your prompt assistance in this matter will be highly appreciated.
Sincerely,
[Sender’s Signature]
[Sender’s Name]
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