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Application Builder/New Humana Forms
Description:Click Link. Click on the Agent Portal (don’t login). Main page, select “Printable Enrollment& Change Forms”. Select App Builder. This allows you to make a custom application that fits your group's every need.
(
, 0k)
For more information: Click Here
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10/19/2012
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Website
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Application Builder/New Humana Forms
Description:Click Link. Click on the Agent Portal (don’t login). Main page, select “Printable Enrollment& Change Forms”. Select App Builder. This allows you to make a custom application that fits your group's every need.
(
, 0k)
For more information: Click Here
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10/19/2012
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Website
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Group Application Checklist
Description:
Checklist for employers submitting a Humana case
(pdf
, 170k)
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3/2/2012
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Download
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HSA Employer Election Form
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3/4/2012
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Download
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Humana STD LTD Master Application 10-99
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3/7/2012
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Download
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Humana STD LTD Master Application 2-9
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3/7/2012
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Download
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Employee Change Form
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10/8/2009
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Download
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Employee Enrollment Form for 100+ employees
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10/8/2009
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Download
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Employee Enrollment Form for 2-19 employees
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10/8/2009
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Download
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Employee Enrollment Form for 20-99 employees
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10/8/2009
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Download
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HumanaLife Beneficiary Form
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10/8/2009
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Download
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COBRA Election Form
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3/4/2012
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Download
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Continuation of Coverage Form
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3/1/2006
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Download
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Humana Group Change Form
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3/7/2012
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Download
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Humana Online
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9/28/2011
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Website
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HSA Custodial Agreement EE pays fee
Description:
For the employees' files. To be used if the employees are paying the account fees.
(pdf
, 155k)
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3/4/2012
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Download
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HSA Custodial Agreement ER pays fee
Description:
For the employees' files. To be used if the employer is paying the account fees.
(pdf
, 155k)
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3/4/2012
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Download
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HSA Custodial Agreement split fee
Description:
For the employees' files. To be used when the employer and the employees are splitting the account fees.
(pdf
, 155k)
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3/4/2012
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Download
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HSA Employer Contribution Form
Description:
To be used if the employer is planning to make a contribution to the employees' HSAs
(pdf
, 76k)
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2/27/2006
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Download
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Humana Dental Brochure
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3/7/2012
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Download
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Humana Disability Brochure 10-99
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3/7/2012
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Download
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Humana Disability Brochure 2-9
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3/7/2012
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Download
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Humana Life Brochure
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3/7/2012
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Download
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Humana Vision Care Brochure
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3/7/2012
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Download
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Humana Vision Discount Plan
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3/7/2012
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Download
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Humana Vitality Employer Brochure
Description:Show your groups how they can work towards lowering their renewal rates!
(pdf
, 8825k)
For more information: Click Here
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11/22/2011
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Download
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Humana Vitality Flyer
Description:Employees earn points towards rewards while working to lower the renewal rates!
(pdf
, 169k)
For more information: Click Here
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11/22/2011
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Download
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Humana Vitality How To Earn Points Sheet
Description:Fact sheet shows how the members can earn points towards rewards from Humana
(pdf
, 459k)
For more information: Click Here
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11/22/2011
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Download
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Humana Vitality Premium Credits Sheet
Description:Sheet explains how the lowered renewal can work for your employer groups.
(pdf
, 110k)
For more information: Click Here
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11/22/2011
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Download
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