Carrier Forms — Employee Benefit Consulting, LLC

Carrier forms

2024 HC-5 Waiver Form (employees waiving medical coverage)

HMAA

HMAA Enrollment Form

HMAA Termination/Change Form

HMAA Group Information Change Form

UHA

UHA Enrollment Form

UHA Termination Form

UHA Change Form

UHA Group Information Change Form

KAISER

Kaiser Enrollment/Change/Termination Form

HMSA

HMSA Enrollment Form

HMSA Membership Report Form

HDS
HDS Enrollment Form

HDS Change Form

HDS Termination Form

HDS COBRA Coverage Election