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GROUP ENROLLMENT/CHANGE REQUEST Attn: Large and Midsize Group Enrollment P.O. Box 10168 Newark, NJ 071013168 Fax (973) 2742297 www.HorizonBlue.comC. Employee Information to be completed by Employee.

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What is large and mid-size group?

Large and mid-size group refers to companies or organizations that have a significant number of employees, typically between 50-1000.

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Large and mid-size group are required to be filed by companies or organizations that fall within the defined range of employees.

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Large and mid-size group can be filled out by gathering all relevant employee and financial information and submitting it to the appropriate regulatory body.

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The purpose of large and mid-size group is to ensure that companies are complying with regulations related to employee benefits and financial reporting.

What information must be reported on large and mid-size group?

Information that must be reported on large and mid-size group includes employee headcount, benefits offered, financial statements, and other relevant data.

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