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Get MA Tufts Health Plan New Case Submission Checklist 2015

10 business days prior to the requested effective date. q Small Group Employer Application completed in full q All Member Enrollment Forms completed in full q Most Recent WR1/Quarterly Wage Statement (Document if employees are full-time, part-time, no longer employed, or new hire) q Small Business Attestation (This form can be submitted when a WR-1 form is not required to be filed) q Signed Verification of Alternative Coverage Forms q Complete census of all eligible employees (Please note if.

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