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Enroll or change health insurance for active TWU 100 employees effective January 1, 2013. Please fax a signed copy of the form to 212-852-8700 or email a signed copy to bscservice mtabsc.org. If you have any questions, please contact the Business Service Center at 646-376-0123. Section 2 - Employee Information BSC ID Print Name Last First Phone (H) Pass # M.I. Email Phone (W) If your address on your pay stub is incorrect, contact the Business Service Center, or log onto www.mtabsc.info.

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