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Small Business Employee Enrollment Form
Blue Shield of California and
Blue Shield of California Life & Health Insurance Company
Effective April 1, 2017Subscriber information Please note: Missing information
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What is reason for application please?
The reason for application is to provide a clear explanation for why the application is being submitted.
Who is required to file reason for application please?
The applicant or the person submitting the application is required to provide the reason for application.
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The reason for application can be filled out by providing a detailed explanation or selecting from a list of predefined reasons.
What is the purpose of reason for application please?
The purpose of the reason for application is to help the recipient understand the motivation behind the submission of the application.
What information must be reported on reason for application please?
The reason for application should clearly state the purpose or justification for submitting the application.
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