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Get Illinois Standard Health Employee Application For Small Employers Form

Information about your health insurance rights under state and federal law, and other resources, please contact the Illinois Department of Insurance s Office of Consumer Health Insurance toll free at (877) 527-9431. INSURER USE ONLY Policy/Group No. Section No. Effective Date New Hire Waiting Period This standard application is intended to simplify your health insurance application process. You will only need to complete this one application, even when your employer has requested quotes fro.

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