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EMPLOYEE HEALTH ENROLLMENT APPLICATION (Group Size 15+) Please PRINT in ink and return to your employer. Use extra sheets of paper if necessary. The Primary Care Physician (PCP) listings of Anthem
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What is employee health enrollment application?
Employee health enrollment application is a form that employees fill out to enroll in health insurance provided by their employer.
Who is required to file employee health enrollment application?
All employees who are eligible for health insurance coverage through their employer are required to file an employee health enrollment application.
How to fill out employee health enrollment application?
Employees can fill out the employee health enrollment application provided by their employer either online or on paper, depending on the instructions given by the company.
What is the purpose of employee health enrollment application?
The purpose of the employee health enrollment application is to collect information from employees regarding their choice of health insurance coverage and to enroll them in the selected plan.
What information must be reported on employee health enrollment application?
Employees must report their personal information, dependent information (if applicable), health insurance plan selection, and any other required details specified in the application form.
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