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STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS OFFICE OF THE JUDGES OF COMPENSATION CLAIMS ORLANDO DISTRICT OFFICE))) Employee/Claimant, ) ) vs.) ) Lake Bennett Health and Rehabilitation,) )
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Lake Bennett Health and is a federal form used to report health coverage information.
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Employers who provide health coverage to their employees are required to file Lake Bennett Health and.
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Employers must report the names, addresses, and Social Security numbers of individuals covered under the health plan.
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