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DO NOT USE FOR INTERNAL PURPOSES ONLYCEWW Health Insurance Consortium GROUP ENROLLMENT FORM nonprofit independent licensee of the Blue Cross Bluesier Association P.O. Box 22999, Rochester, NY 14692HIOS
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Start by entering your personal information, such as your name, date of birth, and contact information.
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b-5858fapcewwhealthinsurancedoc is a form used to report health insurance coverage information to the IRS.
Insurance providers or employers who provide health insurance coverage to individuals are required to file b-5858fapcewwhealthinsurancedoc.
b-5858fapcewwhealthinsurancedoc is filled out with information about the individuals covered by the health insurance, the duration of coverage, and any exemptions from coverage.
The purpose of b-5858fapcewwhealthinsurancedoc is to ensure compliance with the Affordable Care Act by reporting health insurance coverage information to the IRS.
Information such as the names and social security numbers of covered individuals, the months of coverage, and any exemptions from coverage must be reported on b-5858fapcewwhealthinsurancedoc.
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