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Pendent covered under your health insurance. ACTIVE EMPLOYEE NOTICE OF ELECTION (NOE) SOUTH CAROLINA BUDGET AND CONTROL BOARD EMPLOYEE INSURANCE PROGRAM (EIP) BA Use Only Select One: Type of Change Effective Date: New Hire Enrollment Other (specify) Group ID #: Transfer Group Name: Date of Change Event: Change 1. Social Security Number (SSN) 2. Last Name 3. Suf x See Instructions - If Completing By Hand Use Black Ink.

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