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I waive coverage for myself and my eligible tax dependents including my spouse and attest that all will have other minimum essential coverage for the plan year 2017 and the coverage is Other employer-sponsored group coverage e.g. through a spouse or domestic partner TRICARE Medicare Medi-Cal COBRA including through Covered California. This waiver is for the upcoming plan year 2017 and may only be changed during the annual open enrollment period or in the case of a mid-year qualifying...
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