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CLA YCO, INC *5283+($/7+3/$1&225\'$,17,212) %(1(),7648($67,211,5(PLEASE COMPLETE THIS FORM AND RETURN TO:MERCY BENEFIT ADMINISTRATORS PO BOX 14230 SPRINGFIELD, MO 65814Fax: 4178203816 Email: mercybenefitadmin@mercy.net____0(0%(5

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Clayco Inc group health refers to the health insurance plan provided by Clayco Inc to its employees.

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Employees of Clayco Inc who are enrolled in the group health insurance plan are required to file.

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Employees can fill out the necessary forms provided by Clayco Inc during the open enrollment period.

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The purpose of Clayco Inc group health is to provide employees with access to comprehensive health insurance coverage.

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