Current subscribers:
View or download confirmation forms and brochures.

Federal COBRA

Federal COBRA Overview and Model Notices

Model Notice of Extended Election Period

Mini-COBRA Employee Model Notice

Word Document

PDF

2010 TAI Renewal Forms

2010 IBC Small Business Product brochure

TAI Product Confirmation Form

TAI Benefit Election Form

Mandatory CHIP Notice to Employees

CHIP Benefits Bulletin

PA Dependent Coverage to Age 30 - Information & Blue Cross Enrollment Materials

2010 IBC Small Business Product brochure

Mini-COBRA Overview (09/02/2009)

Small Group Rate & Benefit Matrix

Medicare Resource Guide 2009

IBC Flex Benefit Descriptions

IBC Flex Benefit Grid (29.6KB)

IBC High Deductible Benefit Grid (24.9 KB)

IBC Universal Enrollment Form (587KB)

IBC New Small Employer Health Benefits Application (46KB)

IBC Small Employer Certification (23KB)

Aetna Advantage Enrollment Form (453KB)

Click here to access the HIPPA Authorization Form (.14MB)

United Concordia Dependent Certification Form (685KB)

Forms and brochures use Adobe Reader, if you do not have adobe click here for a free download.