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16. SIGNATURE AND CONDITIONAL RECEIPT Check the box that applies: ILLINOIS 2-99 GROUP EMPLOYER APPLICATION We, the employer, as administrator of an Employee Welfare Benefit Plan under ERICA, apply

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What is small group employer application?

Small group employer application is a form that employers with small group health insurance plans must fill out to provide information to insurance carriers and determine eligibility for coverage.

Who is required to file small group employer application?

Employers with small group health insurance plans are required to file the small group employer application.

How to fill out small group employer application?

Small group employer applications can be filled out either online or in paper form. Employers need to provide information about their business, employees, and the health insurance plans they offer.

What is the purpose of small group employer application?

The purpose of the small group employer application is to collect necessary information from employers to determine eligibility for small group health insurance plans.

What information must be reported on small group employer application?

The small group employer application requires employers to report information about their business, such as legal entity type, business address, and industry code. They also need to provide employee information like names, addresses, and employment status.

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