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By entering the enrollment website, you authorize us to facilitate all eligibility and enrollment transactions between you, your employer, and any and all vendors contracted to provide services, coverages and/or benefits. You certify that all information you enter is accurate, complete and true. You further authorize all benefit elections and payroll deductions for those benefits that require a contribution from you.

Your electronic signature as requested and entered on this website is tantamount to you signing the application and provides the same authority as your formal written signature.

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