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2019 ENROLLMENT/CHANGE FORM www.healthpassny.com l P 8883137277 l forms healthpassny. Employee Name:Group Name/Group #:A. Enrollments/Additions Complete A, E, F, O, P and select coverages G N Requested
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Group namegroup refers to a specific categorization or classification used for organizing related entities or individuals within a framework, such as a business, club, or organization.
Entities or individuals who fall under the classification of a group and are obligated to report their activities or data in accordance with the regulations governing that specific group name are required to file.
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The purpose of group namegroup is to facilitate the organization and reporting of activities, ensuring compliance with relevant regulations and providing clarity regarding the structure and operations of the group.
Information that must be reported includes details about the group members, financial status, activities undertaken, and any other data required by regulatory bodies.
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