Safety Kleen - Make Green Work
Insurance Benefits
Billing Statement
 
Demo Student
100 Global View Drive, Suite 800

Warrendale, PA 15086
Account: MB987654321
PU ID: 987654321
Statement Date: 05/01/2008
Due Date: 05/20/2008
Amount Due: $95.00
[Pay By eCheck] [Pay By Credit Card]
 
Please detach this portion of the statement and return with your payment.
Make checks payable to Princeton University - 3E. Mail checks to Heartland ECSI, PO Box 718, Wexford, PA 15090.
Coverage Plan Type Monthly
Premium
Past Due Total Due
HEALTH - PRE-65 UNITEDHLTHCRE PPO EMPLOYEE ONLY $95.00 $95.00
Totals:   $95.00 $95.00
Amount Due by 05/20/2008: $95.00
You can view your recent payment history by using the Payment History link on the Menu.

If you have signed up to have your monthly premium payments deducted electronically from your bank account, you do not have to pay this bill. Your amount due will be deducted on the day you requested. This bill is for informational purposes only. To receive only an electronic notification, please sign up for electronic billing on the web at www.ecsi.net/princeton.
 
For questions regarding your coverage or the retiree health plans, please visit the Princeton University Human Resources web site: http://www.princeton.edu/hr/ben/retire.htm, or contact the Human Resources department at (609) 258-3302. Questions regarding your billing statement should be directed to the Treasurer�s Office at (609) 258-1825.