BPB Associates - Forms
For your convenience, we have included some common group and individual insurance forms and documents.  Please send completed forms to BPB Associates.

Many forms are updated regularly, so please inquire if a form appears to be outdated.  We'll try and maintain as current a list of forms as possible, and add to this list as conditions permit.

Blue Cross Blue Shield of Georgia
 -  Individual Enrollment Application
 -  Individual/Family Dental Brochure
 -  SB476 Acknowledgement
 -  Eligibility Verification Form
 -  Group Master Application
 -  Member Enrollment (2-50 Employees)
 -  Small Group Change Form (2-50 Employees)
 -  Large Group Change Form (51 + Employees)
 -  COBRA

Guardian
 -  Election of Continued Coverage (COBRA)
 -  Beneficiary Change Request
 -  Medical Claim Form
 -  LTD Claim

Humana
 -  Group Master Application (2-50)
 -  Employee Enrollment (2-9 EE's)
 -  Employee Enrollment (10-25 EE's)
 -  Employee Enrollment (26+ EE's)
 -  Dental, Life Enrollment
 -  Evidence of Health Status
 -  Employee Change Form

IMG
 -  Global medical brochure
 -  Global medical application
 -  Patriot Travel (Brochure/Application)
 -  Patriot Executive (Brochure/Application)
 -  Outreach Travel (Brochure/Application)
 -  Outreach Group application
 -  Patriot T.R.I.P (Brochure/Application)
 -  Espanol Global medical brochure
 -  Espanol Global medical application
 -  Espanol Patriot Travel (Brochure/Application)

United Healthcare
 -  Employer Application (2-50 EE's)
 -  Employee Enrollment (2-5 EE's)
 -  Employee Enrollment (6-19 EE's)
 -  Employee Enrollment (20-50 EE's)
__________________________________________________________
Quotes  |   Global   |   Products   |   Companies
Contact   |   Links   |   Link Exchange   |   Forms