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Please, fill the form in less than a minute. Your connection will be secured. All information we collect is strictly confidential. Some useful information about insurances, policies and programs:If your employer offers a fully insured group health plan and has fewer than 20 employees, you may also be eligible for up to 12 month continuation coverage under a U.S. law that is similar to COBRA. However, an eligible person must apply in writing and pay within a 31-day period following termination of the group policy.
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