Employer Application

Employer Statement of Understanding

Chase Application, Group Initiation and Enrollment Form - For groups that have or are selecting PPO 2400 or 3500 plans

Group Admin. Manual - 51-99

EmployerAccess Demo – A great overview of our enhanced employer website that can help you save time, reduce errors and get quick, convenient access to enrollment benefits.

EmployerAccess website – See how you can pay your bills, handle employee transactions and a whole lot more! It's a quicker, easier and more powerful way to manage benefits.

EmployerAccess Manual – A complete guide to our Employer Access website.

HSA Agreement

HSA Addendum

51-99 Check by Fax Form

Demand Debit Authorization (fillable-field)

Conditions of Enrollment for Start-Up Companies/PEO Spin-Off Groups

Health Care Reform Grandfathered Insert

Health Care Reform Guide– There's a lot to know when it comes to the Health Care Reform law. We've created this guide to help you better understand what to expect and when to expect it.