Business Insurance Group Benefits


Group Health & Benefits Forms and Company Information


Below we've tried to compile the most useful forms and information for most of the health and benefits companies we offer, but also feel free to call our office with any questions or to request additional information.

Carriers: Aetna • Altius • DentalSelect • Humana • Humana Specialty • Regence BlueCross BlueShield • SelectHealth • United Healthcare
                                                         

 
 Group Health

  Small Group (2-50 Employees)     
 

Employer: 

  Employee: 
 

Group Application & Forms

  Universal Health Application (New Employee)
  Sales Brochure   Supplemental Application (New Employee)
Provider & Contact Info    Employer Reference Manuals   Change Form 
Member/Employer Login     Forms Selection Link   Forms Selection Link 
Member Discounts & Benefits     Online Application 
Employer Wellness Programs         
Employee Wellness Programs   Large Group (51+ Employees)     
Employee Assistance (EAP)   Employer:    Employee: 
      Group Application & Forms   Enrollment/Change Form (New Employee)
        Sales Brochure   Forms Selection Link 
    Employer Reference Manuals    
    Forms Selection Link    

 
               Group Health              
  Small Group (2-50 Employees)     
 

Employer: 

 

  Employee: 
 

Group Application & Forms

 

  Universal Health Application (New Employee)
  Forms Selection Link   Supplemental Application (New Employee)
Provider & Contact Info      Waiver Form 
Member/Employer Login     Change Form 
Member Discounts & Benefits     Forms Selection Link 
Employer Wellness Programs        Online Application 
Employee Wellness Programs   Large Group (51+ Employees)     
    Employer:    Employee: 
      Group Application & Forms   Enrollment Form (New Employee)
        Risk Evaluation   Statement of Health (New Employee)
    Forms Selection Link   Waiver Form 
      Forms Selection Link
 
 
               Group Dental
  Group    
 

Employer: 

 

  Employee: 
 

Group Application Form

 

  Enrollment Form (New Employee)
  Change Form   Change/COBRA Form
Provider & Contact Info    Additional Forms Link   Additional Forms Link
Member/Employer Login    

 
       Group Health          

 

  Small Group (2-50 Employees)      
 

Employer: 

 

  Employee: 
  New Group Checklist   Universal Health Application (New Employee)
  Group Application & Forms   Suppl/Waiver Application (New Employee)
Provider & Contact Info    Forms Selection Tool   Forms Selection Tool
Member/Employer Login     Online Application  
Member Discounts & Benefits    
Employer Wellness Programs         
Employee Wellness Programs   Large Group (51+ Employees)    
Employee Assistance (EAP)   Employer:   Employee:
      New Group Checklist    Enrollment Form (New Employee)
        Group Application & Forms    Change Form
    Form Selection Tool   Forms Selection Tool

 
 Voluntary Benefits

 

  Group    
 

Employer: 

 

  Employee:
  Master Group Application   Accident Plus Enrollment & Change
  Additional Forms Link   Cancer Plus Enrollment
    Critical Illness Advantage Enrollment & Change
    Critical Life-Term Life Enrollment & Change
      Disability Income Advantage Enrollment
        Secure Life-Whole Life Enrollment
        Supplemental Hospital Enrollment & Change
        Additional Forms Link 


                Group Health
  Small Group (2-50 Employees)    
 

Employer: 

  Employee: 
  New Group Checklist   Universal Health Application (New Employee)
  Group Application & Forms   Supplemental Application (New Employee)
Provider & Contact Info     Additional Forms Link   Authorization for Health Information 
Member/Employer Login       Additional Forms Link
Member Discounts & Benefits     Online Application 
Employer Wellness Programs        
Employee Assistance (EAP)   Large Group (51+ Employees)    
  Employer:   Employee: 
      New Group Checklist    Enrollment/Change Form (New Employee)
        Group Application & Forms   Waiver Form 
    Risk Evaluation Form    Additional Forms Link 
    Additional Forms Link    


        Group Health            

 

  Small Group (2-50 Employees)    
 

Employer: 

 

  Employee: 
  New Group Checklist   Universal Health Application (New Employee)
  Group Application & Forms   Supplemental Application (New Employee)
Provider & Contact Info   Sales Brochure    Waiver Form (New Employee if waiving)
Member/Employer Login   Employer Reference Manual    HSA Enrollment Form (New Employee HSA Plan) 
Member Discounts   Netcare Brochure   Change Form
Employer Wellness   Additional Forms Link    COBRA/Alternative Coverage Form 
Employee Wellness        Additional Forms Link 
        Online Application  
                Large Group (51+ Employees)    
    Employer:    Employee: 
      Group Application & Checklist   Enrollment Form (New Employee)
        Risk Evaluation Form    Change Form 
    Employer Reference Manual   Additional Forms Link
    Additional Forms Link    

 

         Group Health
  Small Group (2-50 Employees)     
 

Employer: 

  Employee: 
  New Group Checklist   Universal Health Application (New Employee)
  Group Application & Forms   Online Application 
Provider & Contact Info        
Member/Employer Login    Large Group (51+ Employees)    
Member Discounts & Benefits   Employer:   Employee:
Employer Wellness Programs    New Group Checklist    Enrollment Form (New Employee) 
Employee Wellness Programs   Group Application & Forms