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UNITEDHEALTHCARE		RELEASED	DOWNLOAD
Employer Enrollment
	1099 Independent Contractors Form	5/14/2013	Download
	2 - 50 Common Ownership Form	5/14/2013	Download
	2 - 50 Product Selection Form Elite Description: Complete in conjunction with 2 - 50 employer application (pdf , 19k)	5/14/2013	Download
	2 - 50 Product Selection Form Signature Description: Complete in conjunction with 2 - 50 employer application (pdf , 22k)	5/14/2013	Download
	2 - 99 Employer Application	12/4/2012	Download
	2 - 99 Select HRA Employer App & Instructions	5/14/2013	Download
	51 - 99 Health Addendum	5/14/2013	Download
	51 - 99 Product and Benefit Selection Form Description: Complete in conjunction with 51 - 99 employer application (pdf , 74k)	5/14/2013	Download
	Employer eServices Enrollment Application	5/14/2013	Download
	Employer eServices Scheduled Direct Debit	5/14/2013	Download
	Navigate PCP Election Form	5/14/2013	Download
Employee Enrollment
	2 - 50 Universal Online Application (English)	5/14/2013	Download
	2 - 50 Universal Online Application (Spanish)	5/14/2013	Download
	51 - 99 EE App w/Health Questions (Spanish)	5/14/2013	Download
	51 - 99 Employee Application w/o Health Questions Description: Only to be used in conjunction with the 51 - 99 Employer Health Addendum (pdf , 50k)	5/14/2013	Download
	51 - 99 Employee Application with Health Questions	5/14/2013	Download
Administration
	Deductible Credit Guidelines	5/14/2013	Download
	Temporary ID Card Instructions	5/14/2013	Download
Claims
	Accelerated Benefits Claim Form	5/14/2013	Download
	Dental Claim Form	5/14/2013	Download
	LTD Claim Form	5/14/2013	Download
	Medical Claim Form	5/14/2013	Download
	OptumRx Mail Order Form	5/14/2013	Download
	OptumRx Rx Reimbursement Form	5/14/2013	Download
	Request for Portability of Critical Illness	5/14/2013	Download
	STD Claim Form	5/14/2013	Download
Other
	2 - 99 New Business Checklist	5/14/2013	Download
	2014 Quick Reference Guide Groups 2 - 99	5/14/2013	Download

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