Carrier Information & Forms

• Aetna
  • Aetna Certification
  • Aetna Employer Application
  • Aetna Waiver of Coverage
  • Aetna Website

• AmeriHealth
  • AmeriHealth Certification
  • AmeriHealth Employer Application
  • AmeriHealth Employee Application
  • AmeriHealth Waiver
  • Amerihealth Website

• Horizon
  • Horizon Certification
  • Horizon Employer Application
  • Horizon Conversion
  • Horizon Employer Application Instructions
  • Horizon Waiver of Coverage
  • Horizon Website

• Medicare
  • Medicare and You
  • Medicare Account Based Plans Guidance
  • Medicare Common Questions
  • Creditable Coverage Disclosure User Manual
  • Creditable Coverage Simplified Determination
  • Entities Required to Provided is Closure
  • Model Creditable Coverage Disclosure Notice
  • Cobertura Acreditable Notice Modelo Revelación en Español
  • Model Non-creditable Coverage Disclosure Notice
  • What is creditable coverage for Medicare?

• Oscar
  • Oscar Certification
  • Oscar Employee Application
  • Oscar Employer Application
  • Oscar ACH Authorization Form
  • Oscar Waiver of Coverage
  • Oscar Website

• Oxford
  • Oxford ATC form
  • Oxford Certification
  • Oxford Employee Application
  • Oxford Employer Application
  • Oxford EPO plan
  • Oxford HMO EE Application
  • Oxford Waiver of Coverage
  • Oxford Website

• Qualcare
  • Qualcare Certification
  • Qualcare Employee Application
  • Qualcare Employer Application
  • Qualcare Health Plan Participation Request / Contract
  • Qualcare BOR (word doc)
  • Qualcare Waiver of Coverage
  • Qualcare Website

• Additional Carrier Links:
  • Health Republic
  • Block Vision
  • Emblem Health

 

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