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Mail this enrollment card along with premium payment to UnitedHealthcare StudentResources PO Box 809026 Dallas TX 75380-9026. PROCESSOR STAMP DATE RECEIVED HERE UNITEDHEALTHCARE INSURANCE COMPANY CONTINUATION ENROLLMENT FORM FOR STUDENTS AND THEIR DEPENDENTS LOYOLA UNIVERSITY - CHICAGO 2011-1291-1 PRIMARY INSURED Complete information below for Student. If premium is not received within 31 days the premium will be refunded. By signing the student acknowledges the following 1 He/She has...
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