Helpful information for small group clients
Helpful information for small group clients
Product portfolios and brochures
Product Portfolios
2024
2023
Benefit Changes
2024
2023
Network Maps
Additional Brochures
2024
- 2023-2024 Grandmothered Small Group Policy Options
- 2024 Together Blue Brochure
- 2024 Preventive Schedule
2023
Vision and Dental Resources
2024
- 2024 Small Group Blue Edge Dental Marketing Brochure (July - December)
- Blue Edge Dental PA RR1 Rate Card 2-50 (July-December 2024)
- 2024 Small Group Pediatric Dental and Vision Brochure
- Blue Edge Vision Plans (2024)
2023
Applications, Waivers, Affidavits
- Small Group HRA Application
- Small Group Business Application (2024)
- Small Group Business Application (2023)
- Enrollment/Waiver Form (2024)
- Enrollment/Waiver Form (2023)
- Start-Up Business Affidavit
- Disability Verification Form
- Disabled Dependent Certification
- Affidavit of Common Law Marriage
- Act 4 Dependent Verification Form
- Domestic Partner Affidavit
- New Employee Affidavit
- Certification of Eligibility to Combine and Employer Group Size
