Commonly used forms
Cancel form for employees or dependents
COBRA Forms
Electronic funds transfer form
Employer portal access request form
Employer portal access request form — Small group
Group plan enrollment/waiver form — 2025
Small group change form
Administer your company’s health benefits with these forms and benefit administration guides.
2025
2025 Small group business application
2025 Enrollment/waiver form — English
2025 Enrollment/waiver form — Spanish
2024
2024 Small group business application
2024 Enrollment/waiver form — English
2024 Enrollment/waiver form — Spanish
General
Authorization for disclosure of health information — Online form
Authorization for disclosure of health information — English PDF
Authorization for disclosure of health information — Hmong PDF
Authorization for disclosure of health information — Spanish PDF
Cancel form for employees or dependents
Authorization for disclosure of health information — Online form
Authorization for disclosure of health information — English PDF
Authorization for disclosure of health information — Hmong PDF
Authorization for disclosure of health information — Spanish PDF
Fully insured plan election form (2024)
Fully insured plan election form (2025)
Self-insured plan election form (2024)
Self-insured plan election form (2025)
Retiree-only group attestation form (2024)
Retiree-only group attestation form (2025)
Premium contribution tool (XLS)
- Only for fully insured groups, to determine grandfathered status
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Employer reporting solution guide
Explore the latest news, training information and helpful resources to enhance your understanding of our employer reporting solution.