Humana Group Enrollment 51+

DocumentDownloadYear
Enrollment Checklist Download
Employer Application Download2019
Ancillary Application Download2014
SBC Attestation Download2013
ACH Authorization Download2010
Full Time Employment Questionnaire Download2005
Small Employer Attestation Download
Enrollment SpreadsheetDownload2018
Employee Change Form Download2009
Plan Change Request Form Download2009
COBRA Election Form English Download2007
Affidavit Of Domestic Partnership Download2014

Download

Download Employer Enrollment Document Packet

Includes all employer documents needed for mid-market group enrollment.
Download
DocumentDownloadYear
Employee Application 51+ Download2016
Prior Carrier Deductible Credit Form Download2017
Pediatric Dental and Vision Highlight Sheet Download2017

Group Resources

Humana Documents

  • Enrollment Checklist

  • Employer Application

  • Employee Application 2-50

  • Employee Application 51+

  • Employee Change Form