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Get Mountaineer Flex Benefits

I UNDERSTAND AND AGREE THAT PEIA AND FRINGE BENEFITS MANAGEMENT COMPANY THE CONTRACT ADMINISTRATOR WILL BE HELD HARMLESS FROM ANY LIABILITY RESULTING FROM EITHER MY PARTICIPATION IN MOUNTAINEER FLEXIBLE BENEFITS OR MY FAILURE TO SIGN OR ACCURATELY COMPLETE THIS ENROLLMENT FORM. RETURN COMPLETED FORM TO YOUR BENEFITS COORDINATOR NO LATER THAN APRIL 30 2011. Mountaineer Flexible Benefits Tax-Free Benefits Paid by Employees If you enroll in a Health.

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