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D-43 – Employee’s Election to Reject Coverage and Election to Waive the Rejection of Coverage for Excluded Persons (NV)

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Omaha National Appoints Joan Klucarich as Chief Actuary
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Omaha National Underwriters, LLC is an MGA licensed to do business in several states including California. CA License NO. 078229.
Coverage is provided by Omaha National Insurance Company, Preferred Professional Insurance Company, and/or Palomar Specialty Insurance Company. Coverage may not be available in all states.