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SECTION 1 INFORMATION REQUIRED FOR REIMBURSEMENT Lifestyle Benefits Reimbursement Form Mail completed form and all required information to Excellus BlueCross BlueShield P. Exercise Classes - Yoga Pilates or Zumba classes must be held in a facility led by qualified instructor. Your 2017 benefit 300 Annual Lifestyle Benefit What it covers Gym Membership - Facility must be open to the public and at a minimum provide both cardiovascular and strength training equipment. Full name and address of...

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