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Dch. georgia.gov/shbp and www. myshbp.ga.gov. It is essential that you carefully read all your materials and answer all the surcharge questions. VI. Coverage Tier - Choose one of the options below - Acronyms Tobacco Tob Spouse Sp Surcharge SC 40 Employee Tob SC 94 Employee Child ren 90 Employee Sp loyee Sp Child ren Tob Sp SC VII. I understand that misrepresentation or falsification will subject me to penalties and possible legal action. SHBP 66-090 rev. 11/2011. For dependents under age two...
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