Group Census Request Form Excel Format

Group Census Form PDF Format

Group Census Online Request Form Online

IBX 2019

IBC Group 2019-Blue-Solutions-Brochure

IBC BOR FORM 2019

IBC 2019-Employer App

IBC 2019-Employee App

BC Waiver Form 2019

BC Eligibility form 2019

BC 2019 Group Checklist

IBX 2018

2018 Blue Solutions- Group Plan Guide

IBX 2018 Employee Application for Blue Solutions (2-50)

IBX 2018 Group Application for Blue Solutions (2-50)

IBCBOREAF_2018

BC Eligibility form

BC 2018 Group Checklist

BC Waiver Form

IBC Small Underwriting Guidelines Final Draft 2017_Broker

 

IBX 2017

2017 Blue Solutions- Group Plan Guide                               

2017 Group Employer Application 

2017 Group Employee Application                            

2017 IBC Group Checklist

BC Waiver Form

 

Aetna                                                                                                         2018 non aca forms

 

United HealthCare

employee 1 to 50 application

employee 50 plus application

employer 1 to 50 application

employer 50 plus application

2018 UnitedHealthcare PA Small Group Portfolio_11 07 17_sortable (Print Ready)

Employer Participation & Floor Certification

PA – 2017 EE Application 2-50

PA – 2017 ER Application 1-50

See attached UHC group paperwork for 2018

 

UHC 2017_PA_Small_Business_Guide_(1-50)

 

Employer Resources

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