FORMS
Ohio Universal Application
AETNA:Individual ApplicationEmployee Applications (2-50 Employees)
ANTHEM:Individual ApplicationIndividual Short-Term ApplicationEmployee Application (2-50 Employees)Employee Application (51+ Employees)Employer QuestionnaireChange Form ApplicationTransmittal of Applications Form
ASSURANT:Individual ApplicationEmployee ApplicationShort-Term Application
MEDICAL MUTUAL:Individual ApplicationEmployee Application (1-19 Employees)Employee Application (20+ Employees)Short-Term Application
PARAMOUNT:Medical History Questionnaire (2-24 Employees)Medical History Questionnaire (25+ Employees)Medical History Questionnarie AddendumOhio HMO Employee ApplicationMichigan HMO Employee ApplicationCDHP Employee ApplicationPPO Employee ApplicationEmployee Termination Notice Form
UNITED HEALTH CARE:Employee Application (2-9 Employees)Employee Application (10-50 Employees)Employee Application (51-99 Employees)
Office Hours:
Monday - Friday8:00am - 4:30pm
1755 Indian Wood Cir.Maumee, OHÂ 43537
4350 Navarre Ave.Oregon, OH 43616
