Form ps 503 2025

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4.9 out of 5

47 votes

The document is a PA Health Insurance Transaction Form (PS-503.1) from the New York State Department of Civil Service, designed for employees to manage their health insurance coverage. It includes sections for personal information, enrollment requests, dependent information, previous coverage details, and authorization for deductions. Employees can request enrollment, decline coverage, change personal details, or update dependent information while being informed about privacy laws and potential penalties for misstatements.

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2007	4.9 Satisfied (47 Votes)

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