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AETNA BETTER HEALTH OF ILLINOIS 3200 Highland Avenue, MC F661 Downers Grove, IL 60515 18666002139 Fax 8607540435Instructions for Electronic Remittance Advice (ERA) Enrollment/Change/Cancellation Page

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How to fill out il era enrollment form

01

Gather all required documents such as proof of identity, proof of address, and any other supporting documents.

02

Complete all personal information fields accurately including name, date of birth, nationality, etc.

03

Fill out the enrollment form completely and ensure all information is correct and legible.

04

Double check all information and make sure all required signatures are obtained.

05

Submit the completed enrollment form along with all necessary documents to the appropriate IL ERA office.

Who needs il era enrollment form?

01

Individuals who are applying for enrollment in the IL ERA program.

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What is il era enrollment form?

The il era enrollment form is a form used for enrolling in the Illinois Employee Retirement System.

Who is required to file il era enrollment form?

All employees who are eligible for membership in the Illinois Employee Retirement System are required to file the il era enrollment form.

How to fill out il era enrollment form?

The il era enrollment form can be filled out online or through a paper form provided by the employer. Employees need to provide personal information, employment details, and beneficiary information.

What is the purpose of il era enrollment form?

The purpose of the il era enrollment form is to enroll employees in the Illinois Employee Retirement System and gather important information for retirement benefits.

What information must be reported on il era enrollment form?

The il era enrollment form requires information such as personal details, employment history, beneficiary information, and enrollment options.

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