| Download |
Application Supplement - FL |
| Download |
Application Supplement - GEN |
| Download |
Arkansas Application |
| Download |
Association Group States Application for: AL, AZ, IL, IN, MI, MS, MO, NE, OH, SC & VA. |
| Download |
Colorado & Georgia Application |
| Download |
Colorado Determination of Self-Employed Business Group of One Form |
| Download |
Colorado Notice Form |
| Download |
Colorado Notice Regarding Replacement Form |
| Download |
Florida Application |
| Download |
Request for Rewrite of Existing Health Insurance |
| Download |
Texas Application |
| Download |
Arkansas Consumer Compensation Disclosure Form |
| Download |
Authorization to Disclose Protected Health Information |
| Download |
Colorado 2006 Standard Health Benefit Plans Description |
| Download |
Colorado Health Plan Description Form for the Quantum Care Complete Plan |
| Download |
Colorado Health Plan Description Form for the Quantum Care Basic Plan |
| Download |
Colorado Health Plan Description Form for the Quantum Care Essential Plan |
| Download |
Employers Acceptance of Payroll Deduction Plan (List Bill Forms ASIM-PDP-1-3 10/06) |
| Download |
Express Scripts 2007 Drug Formulary List |
| Download |
Express Scripts Pharmacies By State |
| Download |
Georgia Outline of Coverage for Basic Plan |
| Download |
Georgia Outline of Coverage for Complete and Essential Plans |
| Download |
Georgia PPO Notice |
| Download |
HIPAA Eligibility Questionnaire |
| Download |
IAC PreScreen Form |
| Download |
Quantum Care Series Rate Calculation Worksheet |
| Download |
Quick Reference Guide |
| Download |
Quick Reference Guide Insert for Quantum Care Series and Quantum Care High Deductible plans |
| Download |
Risk Assessment Guide: Comprehensive Risk Assessment Guide |
| Download |
Select Fax Application Cover Sheet |
| Download |
Select Fax Instructions |
| Download |
Simple Verification Phone Script |
| Download |
Third Party Payor Plan Form and Patrons Statement of Eligibility & Authorization for 3rd Party Billing Form |
| Download |
Web Site Guide |
| Download |
12-Month Initial Premium Rate Guarantee Rider - Association Group |
| Download |
12-Month Initial Premium Rate Guarantee Rider - CO & GA |
| Download |
24-Hour Occupational Coverage Rider - Association Group |
| Download |
24-Hour Occupational Coverage Rider - CO |
| Download |
24-Hour Occupational Coverage Rider - GA |
| Download |
Certificate - Association Group |
| Download |
Certificate - FL |
| Download |
Certificate - TX |
| Download |
Dental Anesthesia Benefit Rider (optional) - MS |
| Download |
Diabetes Benefit Rider (optional) - MS |
| Download |
Enhanced Routine Preventive Care Benefits Rider - AR |
| Download |
Enhanced Routine Preventive Care Benefits Rider - CO |
| Download |
Enhanced Routine Preventive Care Benefits Rider - FL |
| Download |
Enhanced Routine Preventive Care Benefits Rider - GA |
| Download |
Enhanced Routine Preventive Care Benefits Rider - GEN |
| Download |
Enhanced Routine Preventive Care Benefits Rider - TX |
| Download |
Mammography Benefit Rider (optional) - MS |
| Download |
Nervous & Mental Disorder Option Rider - GA |
| Download |
Policy - CO |
| Download |
Policy - GA |
| Download |
Prescription Drug Card Rider - Association Group |
| Download |
Prescription Drug Card Rider - CO |
| Download |
Prescription Drug Card Rider - GA |
| Download |
Prescription Drug Card Rider - Generic (WC) - MO |
| Download |
Prescription Drug Card Rider - Generic (WOC) - MO |
| Download |
Prescription Drug Card Rider - Generic - AR |
| Download |
Prescription Drug Card Rider - Generic - CO |
| Download |
Prescription Drug Card Rider - Generic - FL |
| Download |
Prescription Drug Card Rider - Generic - GA |
| Download |
Prescription Drug Card Rider - Generic - GEN |
| Download |
Prescription Drug Card Rider - Generic - IL |
| Download |
Prescription Drug Card Rider - Generic - TX |
| Download |
Prescription Drug Card Rider - IL |
| Download |
Prescription Drug Card Rider - TX |
| Download |
State Amendment Rider - AR |
| Download |
State Amendment Rider - AZ |
| Download |
State Amendment Rider - FL |
| Download |
State Amendment Rider - IL |
| Download |
State Amendment Rider - IN |
| Download |
State Amendment Rider - MS |
| Download |
State Amendment Rider - SC |
| Download |
Supplemental Accident Benefit Rider - Association Group |
| Download |
Supplemental Accident Benefit Rider - CO & GA |
| Download |
Supplemental Accident Benefit Rider - FL |
| Download |
TMJ Benefit Rider (optional) - MS |
