Group Materials
For Your Business
Forms and Resources
- Active&Fit Direct Flier
- Be Healthy Wellness Guide
- Benefit Administrator’s Guide
- BPC Service Setup Sheet
- College Extended Network Program Flier
- Healthy Extras Flier
- Helping You Be Your Best Programs Flier
- HIPAA Authorization Form (En español)
- Key Things to Know and Do
- New Member Video
- Online Premium Bill Pay Flier
- Self-Funded BenefitFocus Flier
- SHOP Tools and Calculators
- SHOP Tools and Calculators in Spanish
- Small Group Vision Buy Up
- Small Group Dental Buy Up
- Small Group EHB Vision/Dental Public Flier
- Small Group EHB Vision/Dental Private Flier
- IA Small Group EHB Vision/Dental Private Flier
- Treatment Cost Calculator Flier
- Why Choose a Self-Funded Plan?
- Commercial Virtual Visit Member Flier
Medicare Materials
- 2018 Midwest Group Medicare Brochure
- Group Medicare Employees Flier
- 2018 IL/IN Group Medicare Plan Inserts
- 2018 Group Medicare Supplement Rates, Non-Chicago
- 2018 Group Medicare Supplement Rates, Chicago
- 2020 Group Medicare Supplement Rates, Non-Chicago
- 2020 Group Medicare Supplement Rates, Chicago
- Choosing a Medigap Policy Booklet
- Medicare Be Healthy Wellness Guide
Applications
2018/2019
- 2018 IA Large Group Exhibit B
- 2018 IA Small Group Exhibit B
- 2018 IA Small Group Employer Application
- 2018 IL Large Group Exhibit B
- 2018 IL Small Group Employer Application
- 2018 IL Small Group Exhibit B
- 2018 Large Group and Self-Funded Employee Application
- 2018 Large Group Employer Application
- 2018 IL Small Group Employee Application
- 2018 IA Small Group Employee Application
- 2018 WA Small Group Employee Application
- 2018 WA Small Group Employer Application
- Small Group Quote Checklist
- WA Small Group Quote Checklist