Common Contracts
1 similar null contracts
Underwritten Quote Submission Procedures and Check ListSeptember 2nd, 2015
Received Date Received Document and Description Milliman Services Agreement – This form has to be completed and signed by the broker and theclient in order to set the group up in the HERO Underwriting System for online health questionnaires. Employer Group Application – completed online in the HERO Underwriting System -This form must be completed with all information requested –This form must be signed and dated by the employerAND the producer. Prior Carrier Bill - If this plan is replacing current group coverage, please provide invoices from monthprior to requested effective date. Signed and returned PPO Network Contract and supporting documents needed by network provider. A copy of the Renewal Rates from the in-force carrier with claims experience when available. A copy of the Current Plan of Benefits. A copy of the preliminary proposal must be included with the group submission. Executed Plan Service Agreement Employee Enrollment Forms – completed
