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About Us
Services
Careers
Customers
Contact Us
Employees
COVID-19

Employee Documents

Enrollment Form (pdf)Download

ASCII Groups LLC - Premium Conversion Election Form and Salary Reduction Agreement (pdf)Download

ASCII Groups LLC - (POP) Summary Plan Description(SPD) (pdf)Download

COBRA General Notice (pdf)Download

Marketplace model notice (pdf)Download

HIPAA Notice of Special Enrollment Rights (pdf)Download

HIPAA Notice of Privacy Practices (NPP) (pdf)Download

CHIPRA Model Notice (pdf)Download

Medicare Part D Model Notice - for 60+ (pdf)Download

Model WHCRA Enrollment Notices (pdf)Download

Patient Protection Model Notice (pdf)Download

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