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Extended Health Care Claim Form Attach Original Receipts - AFBS

Extended Health Care Claim Form Attach Original Receipts - AFBS 2025

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The document is an Extended Health Care Claim Form from the Actra Fraternal Benefit Society (AFBS) that provides instructions for members to file claims for health care expenses. It includes sections for member information, claim details, coordination with other insurers, and authorization. Members are required to submit original receipts and complete all necessary sections before sending the form to AFBS. Additional notes emphasize the importance of accuracy and confidentiality in handling personal information.

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