[access capability=”group_sc_level_01″]
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
To make changes to your current plan offerings, please complete the online form using the link below, or submit the enclosed change form via one of the submission methods below. You will need to notify your members of any changes made.
Group Documents
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – due by October 9, 2018
- Sample Member Renewal Letter PDF
- Member Change Form PDF (or fillable form through the portal) – due by December 3, 2018
- Payment Authorization Form
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]
[access capability=”agent_sc_level_02″]
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
Sponsoring Entities will be receiving their renewal kits through our Group Portal or via certified mail. Groups will receive their renewal information through the portal or via certified mail between September 24, 2018 and October 1, 2018.
Groups will receive the following documents in their renewal information:
Group Documents
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – 2018 Form deadline has expired
- Sample Member Renewal Letter PDF
- Member Change Form PDF – 2018 Form deadline has expired
- Payment Authorization Form
- Listing of active participants is available online via group portal. All groups are set up with a portal.
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]
[access capability=”agent_sc_level_03″]
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
Sponsoring Entities will be receiving their renewal kits through our Group Portal or via certified mail. Groups will receive their renewal information through the portal or via certified mail between September 24, 2018 and October 1, 2018.
Groups will receive the following documents in their renewal information:
Group Documents
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – 2018 Form deadline has expired
- Sample Member Renewal Letter PDF
- Member Change Form PDF – 2018 Form deadline has expired
- Payment Authorization Form
- Listing of active participants is available online via group portal. All groups are set up with a portal.
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]
[access capability=”agent_sc_mfd_level_02″]
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
Sponsoring Entities will be receiving their renewal kits through our Group Portal or via certified mail. Groups will receive their renewal information through the portal or via certified mail between September 24, 2018 and October 1, 2018.
Groups will receive the following documents in their renewal information:
Group Documents
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – 2018 Form deadline has expired
- Sample Member Renewal Letter PDF
- Member Change Form PDF – 2018 Form deadline has expired
- Payment Authorization Form
- Listing of active participants is available online via group portal. All groups are set up with a portal.
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]
[access capability=”agent_sc_mfd_level_03″]
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
Sponsoring Entities will be receiving their renewal kits through our Group Portal or via certified mail. Groups will receive their renewal information through the portal or via certified mail between September 24, 2018 and October 1, 2018.
Groups will receive the following documents in their renewal information:
Group Documents
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – due by No Longer Available
- Sample Member Renewal Letter PDF
- Member Change Form PDF (or fillable form through the portal) – due by December 1, 2018
- Payment Authorization Form
- Listing of active participants is available online via group portal. All groups are set up with a portal.
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]
[access capability=”administrator”]
NOTE TO ROGER – BELOW ARE THE HREF LINKS TO ADD WHEN THE FILES BECOME AVAILABLE
Group Documents
[insert_php] echo date(‘l, F jS, Y’); [/insert_php]
Sponsoring Entities will be receiving their renewal kits through our NEW Group Portal or via certified mail. Groups will receive their renewal information through the portal or via certified mail between September 24, 2018 and October 1, 2018.
Groups will receive the following documents in their renewal information:
- Sample Sponsoring Entity Renewal Letter PDF
- Sponsoring Entity Change Form PDF – 2018 Form deadline has expired
- Sample Member Renewal Letter PDF
- Member Change Form PDF
- Payment Authorization Form
- 2019 Prescription Benefit and Rate Sheet
- 2018 Prescription Benefit and Rate Sheet
- Listing of active participants is available online via group portal. All groups are set up with a portal.
Please note: Members that are part of a group billed account will not receive a member renewal kit.
[/access]