Below you will find all of the Life & Health forms that we have available for download.  All forms are organized by their relevant carrier.  If you are unable to find the form that you are looking for, please contact us.

Please Select Carrier or Category

Aetna     Blue Cross     Principal     United Healthcare     General

Life & Health Forms > Aetna

Employee Enrollment Form 1-50 (Download: employee_enrollment_form_1-50_(aetna).pdf)

Employee Enrollment Form 1-50 (Spanish) (Download: employee_enrollment_form_1-50_spanish_(aetna).pdf)

Claim Form HMO & QPOS (Download: claim_form_hmo_&_qpos_(aetna).pdf)

Claim Form PPO (Download: claim_form___ppo_____(aetna).pdf)

Rx Claim Form (Download: rx_claim_form_(aetna).pdf)

Dental Claim Form (Download: dental_claim_form_(aetna).pdf)

Master Group App 1-50 (Download: master_group_app_1-50_(aetna).pdf)

Group Medical Questionnaire for 10+ Groups (Download: group_medical_questionair_for_10+_groups_(aetna).pdf)

Life & Health Forms > Blue Cross

Employee Enrollment or Change Form 1-50 (Download: employee_enrollment_form_1-50_(bcbs)_3.pdf)

Instructions for Employee Enrollment form 1-50 (Download: employee_enrollment_form_1-50_(bcbs)_instructions.pdf)

Group Health PPO Claim Form (Download: group_health_ppo_claim_form_(bcbs).pdf)

Rx Claim Form (Download: rx_claim_form_(bcbs).pdf)

Employee Enrollment Dental (Download: group_member_life_&_dental_enrollment_application_50625_-_1006.pdf)

Group Dental Claim Form (Download: group_dental_claim_form_(bcbs).pdf)

Master Group App 1-50 (Download: new_business_small_emp_app_2074_0805_sr.pdf)

Master Group App-Dental 1-50 (Download: employer_application_for_group_dental_insurance_50401_-_0904r_sr.pdf)

Group Medical Questionnaire 4-50 (Download: group_medical_questionair_4-50_(bcbs).pdf)

HIPAA Authorization Form (Download: hipaa_authorization_form_(bcbs).pdf)

Life & Health Forms > Principal

Employee App (Download: employee_app_(principal).pdf)

Medical Claim Form (Download: medical_claim_form_(principal).pdf)

Rx Claim Form (Download: rx_claim_form_(principal).pdf)

Member Change Form (Download: member_change_form_(principal).pdf)

Group Dental Claim Form (Download: group_dental_claim_form_(principal).pdf)

Master App Dental & Life (Download: master_app_dental_&_life_(principal).pdf)

Life & Health Forms > United Healthcare

Employee Enrollment Form (Download: employee_enrollment_form_(united).pdf)

Addtl Dependents Form (Download: addtl_dependents_form_(united).pdf)

Medical Claim Form (Download: medical_claim_form_(united).pdf)

Dental Claim Form (Download: dental_claim_form_(united).pdf)

Prescription Drug Reimbursement Form (Download: prescription_drug_reimbursement_form_(united).pdf)

Leased Employee Form (Download: uhc_peo-lease_form.pdf)

Common Ownership Form (Download: uhc_common_ownership_form.pdf)

Employer App (Download: employer_app_(united).pdf)

Benefit Selection Form (Download: benefit_selection_form.pdf)

Eff 6-9-05 ER Med Questions (Download: eff_6-9-05_er_med_questions.pdf)

Life & Health Forms > General

Group AOR Change (Download: sihle_insurance_group_aor_change.pdf)

Life & Health Forms > Aetna

Aetna Small Group Medical Questionnaire (Download: aetna_small_group_medical_questionnaire.pdf)

Life & Health Forms > Blue Cross

Group Medical Questionnaire 4-50 lives (Download: bcbs_group_medical_questionnaire_4-50_lives.pdf)

Evidence of Insurability/Employee Application (Download: evidence_of_insurability_-_employee_application_50474_-_1201_sr.pdf)

Health & Financial Enrollment Application (Download: health_&_financial_enrollment_application_22095_706_sr.pdf)

Health & Financial Change Application (Download: health_&_financial_change_application_22411_-_906_sr.pdf)

Blue Cross Enrollment Form - One Page (Download: bc_enrollment_form_1page.pdf)

Blue Cross Change Form - One Page (Download: bc_change_form.pdf)