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CLA YCO GROUP HEALTH PLAN ACCIDENT QUESTIONNAIREPLEASE COMPLETE THIS FORM AND RETURN TO:MEMBER NAME:___MERCY BENEFIT ADMINISTRATORS PO BOX 14230 SPRINGFIELD, MO 65814MEMBER ID #:Fax: 4178203816 Email:

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How to fill out clayco inc medical plan

01

Obtain the necessary forms for the Clayco Inc medical plan from the HR department.

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Fill out the personal information section including your name, address, date of birth, and Social Security number.

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Provide details about your current health insurance coverage, if applicable.

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Indicate your choice of medical plan options offered by Clayco Inc.

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Sign and date the form before submitting it back to the HR department for processing.

Who needs clayco inc medical plan?

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Employees of Clayco Inc who are eligible for benefits.

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Anyone looking for comprehensive medical coverage through their employer.

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What is clayco inc medical plan?

Clayco Inc medical plan is a health insurance plan provided by the company for its employees.

Who is required to file clayco inc medical plan?

All eligible employees of Clayco Inc are required to enroll in the medical plan.

How to fill out clayco inc medical plan?

Employees can fill out the medical plan by providing their personal information, selecting coverage options, and submitting the form to the HR department.

What is the purpose of clayco inc medical plan?

The purpose of Clayco Inc medical plan is to provide healthcare coverage to employees and their dependents.

What information must be reported on clayco inc medical plan?

The medical plan requires information such as personal details, dependent information, coverage selections, and beneficiary designations.

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