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Kentucky Employees Health Plan Department of Employee Insurance Keep.KY.gov 1.888.581.88342017 KEEP ACTIVE EMPLOYEE HEALTH INSURANCE QUALIFYING EVENT FORM Section 1: To Be Completed by Insurance Coordinator/HRGKHRIS
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Section 1 to be is the part of the form where the employee provides their personal information.
All employees are required to fill out section 1 of the form.
Employees need to provide personal information such as name, address, social security number, and eligibility to work in the country.
The purpose of section 1 is to verify the identity and eligibility of the employee to work in the country.
Information such as name, address, social security number, date of birth, and citizenship status must be reported on section 1.
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