2020 FORMS

Group Benefit Enrollment & Change Form | All Lines Group Benefit Enrollment & Change Form | Non-Medical Demographic Change Form

HIPAA Forms

Waiver of Medical Coverage Form

(Includes Notice of Special Enrollment Rights and Consequences of Declining Coverage)

HIPAA Authorization for Release of Personal Health Information (PHI)

Domestic Partnership Forms

Affidavit of Domestic Partnership Declaration of Termination of Domestic Partnership

COBRA

COBRA Notice to Employer of a Qualifying Event