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Reimbursement form - UHC

Reimbursement form - UHC

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UnitedHealthcare Sweat Equity Reimbursement Program P.O. Box 740806 Atlanta, GA 30374 These documents must be mailed to us (postmarked) no later than 180 days from your program end date. Requests postmarked after this date won’t be reimbursed. continued. Please print . Member. 1. information. Member First Name: Member Last Name: Date of Birth ...

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