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ENROLLMENT & CHANGE FORM Underwritten by: NATIONAL HEALTH INSURANCE Third Party Administrator: Maritain 1405 Medium Lane North, Suite 140, Minneapolis, MN 55441 8008478361 Fax Enrollment/Change Form
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Underwritten by national health are the medical services and treatment costs covered by a national health insurance program.
All taxpayers who are enrolled in the national health insurance program are required to file underwritten by national health forms.
To fill out underwritten by national health forms, taxpayers need to provide details about their medical expenses and treatments received.
The purpose of underwritten by national health is to report and track the medical expenses covered by the national health insurance program.
Taxpayers must report details such as the date of medical treatment, the name of the healthcare provider, and the amount paid for each service.
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