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2024 Health Renewal
2024 Health Renewal
Firm Name
*
Firm ID
Do you wish to change plans?
Yes
No
If Yes, select new plan for 2024-2025
Blue Options PPO Plan 1
Blue Options PPO Plan 2
Blue Options PPO Plan 3
Blue Options PPO Plan 4
Blue Options PPO Plan 5
HDHP Plan 10
HDHP Plan 15
HDHP Plan 20
Primary Contact Name
Primary Contact Email
What % of the Employee’s health plan cost is paid by the Employer (minimum 50%)
Have all attorneys participating in the health plan renewed NC Bar Association membership?
Yes
No
Submit
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