My renewal packet already has some of my information. Why are other areas blank?

The renewal packet may include some of your information that we have on file. Your PEAK account may include more information than your renewal packet.

You need to review the current information we have in the renewal packet for all members of your household.

• If the information is blank but applies to you, add the information.
• If the information is not correct, add the correct information.
• If you need to add more information, there’s a blank page at the end of the packet for you to write it in.

After you make the updates to the packet, sign the Renewal Form Signature Page, and return the form to your local county human services department by your renewal deadline.

If you do not have changes to your information, sign and return the Renewal Form Signature page to your local county human services department by your renewal deadline.

Important: If you do not return the Renewal Form Signature Page by the deadline, you may lose your health care coverage.