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Processor Date Stamp Received HereUNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK CONTINUATION ENROLLMENT FORM FOR STUDENTS AND THEIR DEPENDENTS SUN POTSDAM20169071PRIMARY INSURED COMPLETE INFORMATION
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What is coverage will be effective?
Coverage will be effective when all required information is accurately reported.
Who is required to file coverage will be effective?
All individuals or entities who are covered under the policy are required to file coverage will be effective.
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The purpose of coverage will be effective is to ensure that all individuals or entities have the necessary insurance coverage.
What information must be reported on coverage will be effective?
Information such as policy number, coverage amounts, effective dates, and the names of individuals covered must be reported on coverage will be effective.
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