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RBG, TAMPA-FT. MYERS - FORMS
UNITEDHEALTHCARE RELEASED DOWNLOAD
Employer Enrollment
Employer Application
5/13/2019   Download
New Business Checklist

Description:
A checklist to make sure have all materials for a new sale. (pdf , 449k)

5/13/2019   Download
Participation & Floor Certification

Description:
Can be used for groups with 10+ eligible in lieu of tax documents. (pdf , 108k)

5/13/2019   Download
Product an Benefit Selection Form

Description:
Used for plan choices. (pdf , 25k)

5/13/2019   Download
Employee Enrollment
Employee Enrollment Form
5/13/2019   Download
Administration
Common Ownership Form
2/10/2017   Download
Direct Debit Authorization Form

Description:
Can be used in lieu of the Binder Check (pdf , 178k)

5/13/2019   Download
Other
2019 RBG Census Template
11/5/2018   Download