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Instructions for PAY 985 Enrollment Formalization Instructions:
Enrolled: Please legibly fill out the information at the top of the form. Supervisor: Only current departmental faculty member (assistant,
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What is enrollee please legibly fill?
Enrollee must provide their personal information and insurance details.
Who is required to file enrollee please legibly fill?
Any individual enrolled in a health plan or insurance program.
How to fill out enrollee please legibly fill?
Enrollees can fill out the form either online, by mail, or in person.
What is the purpose of enrollee please legibly fill?
The purpose is to collect accurate information about individuals enrolled in health plans for administrative purposes.
What information must be reported on enrollee please legibly fill?
Enrollees must report their name, address, contact information, insurance policy number, and any other relevant details.
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