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Clear Page COBRA NOTICE CONTINUATION OF HEALTH BENEFITS COVERAGE UNDER COBRA HC-0806-1012 STATE HEALTH BENEFITS PROGRAM AND SCHOOL EMPLOYEES HEALTH BENEFITS PROGRAM This page is to be completed by

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What is hc 0806 1012 form?

HC 0806 1012 form is a document used for reporting certain information to the appropriate authority.

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The individuals or entities specified by the authority are required to file hc 0806 1012 form.

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