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Confirmation Code: CB-F03A-D02E

Contact Info
Name: SHANE MINTZ
Email: swmintz@hotmail.com
Phone: (406)439-3995
Additional Coverages
Spouse Coverage
Coverage Types: Medical, Dental, Vision, Rx Card
Name of other insurance: Allegiance
Insurance company phone #: (800)877-1122
Effective date of coverage: 1/1/2019
Policy holder's name: Wendy Mintz
Policy holder's ID #: 779742825322
Policy holder's date of birth: 8/16/1969
Is coverage a result of a court order? No
Is this Medicare coverage? No
dependent
Relation: Spouse
Name: Wendy Mintz
Notes:
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