The following information is required when submitting a new group application for benefits:
- Group Application
- Company check (for first month’s premium)
- Employee enrollment forms
- Proof of prior coverage (not applicable for Co-pay and Discount plans)
- Summary of benefits from prior plan
- Last month’s invoice from prior plan
- Employee effective dates on prior plan
- Census (Contributory plans & Voluntary Indemnity plans (Utah & Texas) or PPO plans (Utah only) with less than 5 enrolled)
- Waiver enrollment forms (Contributory plans only)
For your convenience, a New Group Submittal Checklist is available under Forms.