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PROCESSOR STAMP DATE RECEIVED HERE UnitedHealthcare INSURANCE COMPANY CONTINUATION ENROLLMENT FORM FOR STUDENTS VANGUARD UNIVERSITY 20139231 PRIMARY INSURED Complete information below for Student.
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923-1 continuation form-v1 layout is a continuation form used for reporting additional information related to the original form 923-1 layout.
Entities or individuals who have additional information to report related to the original form 923-1 layout are required to file the 923-1 continuation form-v1 layout.
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The purpose of the 923-1 continuation form-v1 layout is to allow for the reporting of additional information that was not included in the original form 923-1 layout.
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