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Large Group Enrollment / Change Form Group Name: Folsom Cordova Unified School District #078103Effective Date:JULY 1, 2017New EnrollmentChangeReason for Request: Annual open enrollment Newly eligible

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What is large group enrollment change?

Large group enrollment change refers to the process of updating the enrollment of a large group of individuals in a health insurance plan.

Who is required to file large group enrollment change?

Employers or organizations that provide health insurance coverage to a large group of individuals are required to file large group enrollment change.

How to fill out large group enrollment change?

Large group enrollment change can be filled out by providing the necessary information about the individuals in the group and submitting it to the insurance provider.

What is the purpose of large group enrollment change?

The purpose of large group enrollment change is to ensure that the insurance provider has up-to-date information about the individuals covered under the plan.

What information must be reported on large group enrollment change?

The information that must be reported on large group enrollment change includes the names, dates of birth, and any changes in coverage status of the individuals in the group.

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