This form is to securely send employee benefit enrollment documentation to MMIA. This is not for submission of medical claims, UI5 or employee payroll information.
• Do not send UI5 or employee payroll documents here, send them through the MMIA site (https://mmia.net/send-a-document) under the "Finance" tab.
• To submit a medical claim to Allegiance, please visit www.askallegiance.com.
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