Welcome To Contractor's Choice

Carrier Forms

Aetna - Employee Enrollment Change Form

Anthem Blue Cross - Employee Application

ASH - Employee Application

ASH - Group Election Form

ASHIC - Employee Enrollment Form (National)

Assurity - Beneficiary Designation Form

Assurity - Claim Form

Assurity - Employee Application

Assurity - Group Application

Blue Shield - Change Form (English)

Blue Shield - Change Form (Spanish)

Blue Shield - Claim Form

Blue Shield - Continuity of Care Form (English)

Blue Shield - Continuity of Care Form (Spanish)

Blue Shield - Domestic Partnership Affidavit

Blue Shield - Employee Application (Spanish)

Blue Shield - Employee Application Form

Blue Shield - Full Time Student Certification

Blue Shield - Group Application

Blue Shield - Refusal of Coverage Form

Blue Shield - Rx Claim Form

Delta Dental - Dual Choice Enrollment Form (Spanish)

Delta Dental - Dual Choice Enrollment Form

Delta Dental - Enrollment Change Form (Allied Administrators)

Delta Dental - Master Group Application

Domestic Partner Affidavit

EyeMed - EnrollmentChange Form

Fortis - Employee Application

Health Net - Enrollment Form

Health Net - Group Enrollment Form

HUMANA - Employee Change Form

HUMANA - Employee Enrollment Form

Kaiser - Declination of Coverage

Kaiser - Employee Application (English)

Kaiser - Employee Application (Spanish)

Kaiser - Group Application

Kaiser - HIPAA Authorization

Premier Access - Employee Enrollment Change Form

Prescription Solutions - Rx Claim Form

SafeGuard - Group Vision Form

SafeGuard - Plan B Enrollment Form

SafeGuard - Vision Enrollment Form

Sekure - Health Access Mexico Enrollment Form

Symetra - Enrollment Form

The Standard - Group Enrollment Change Form

UHC - California COBRA Election

UHC - HMO Change Request Form (English)

UHC - HMO Change Request Form (Spanish)

UHC - Dental & Vision Enrollment Form

UHC - Dental Enrollment Form (English)

UHC - Dental Enrollment Form (Spanish)

UHC - Group Application

UHC - HMO Continuity of Care Form

UHC - HMO Enrollment Form (English)

UHC - HMO Enrollment Form (Spanish)

United Healthcare - Employee Enrollment Form

United Healthcare - HSA Application

United Healthcare - PPO Application (English)

United Healthcare - PPO Application (Spanish)

VSP - Application

Western Health - Employer Group Application

Western Health - Enrollment Change Form (Spanish)

Western Health - Enrollment Change Form

COBRA

COBRA - Beneficiary Takeover Form

COBRA - Initial Notification Form

New Case

Contractor's Choice - Business Associate Agreement

Contractor's Choice - Direct Deposit Form

Contractor's Choice - Group Info Form

Contractor's Choice - Hour Bank Time Line

Contractor's Choice - Hours & Contribution Form

Contractor's Choice - New Carrier Info

Contractor's Choice - Non-Trust Submission Checklist

Contractor's Choice - Participation Agreement

Contractor's Choice - Submission Checklist

Contractor's Choice - Trust Agreement

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