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Get UCSF UPAY 850 2005

Cel, or opt out of insurance plans for yourself and/or your eligible family members. For complete information on eligibility, effective dates, and allowable actions, see Your Group Insurance Plans, available on the At Your Service website (atyourservice.ucop.edu) or from your department or Benefits Office. If the only action you require is to add or cancel coverage for a family member or to change personal data for a family menber, you must complete Sections 1, 2, and 5. List only the eligible.

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