MyMIGDashboard
Chat Now
Martin Speaks
AMERIHEALTH
- 2020 IHC Application
- 2019 SEH Underwriting Guidelines
- 2019 SEH New Business Kit
- 2019 SEH Certification
- AmeriHealth HSA PNC Group Application
- Copay Reimbursement Form
- DU31 Application
- Electronic Withdrawl of Initial Payment Letter
- Future Scripts Rx Mail Order Form 2-50
- Future Scripts Rx Prior Authorization Form
- Future Scripts Rx Reimbursement Form 51+
- Guest Advantage Application
- Handicap Child Claim Form
- Large Group Change Form
- Large Group Enrollment Form
- Large Group Underwriting Guidelines
- Plan Change Form
- Portal Access Form
- POS Claim Form
- PPO Claim Form
- Prior Carrier Deductible Credit
- Small Group Member Application
- Small Group Waiver of Coverage
- Declaration of Understanding
- Enrollment Change Request Form
- Davis Vision Reimbursement Claim Form
- Dental Claim Form
- HIPAA Authorization for Disclosure of Health Info
- Out of Pocket Maximum Reimbursement Form
- Disabled Dependent Form
- 2020 Individual Application
- 2020 Group Application
- 2020 SHOP Application
- HSA Funding Form
- Horizon General Claim Form
- NEW HSA Setup Form effective 1/1/19
- Disabled Dependent Form
- Declaration of Understanding
- Spanish Version: Waiver of Coverage
- Spanish Version: Enrollment Change Form
- Spanish Version: New Group Application
- SEP & Documentation for Health Plans Purchased Off-Exchange
- Highlighted Small Group Enrollment/Change Request
- Small Employer Common Ownership Certification
- Individual Dental Brochure & Application
- 2019 Termination Request Letter
- Away from Home Care Services Application
- Small Group Enrollment/ Change Request
- Spanish Version: Special Enrollment Documentation Requirements
- Small Employer Certification
- Small Employer Waiver
- Auto Pay Application
- 2-5 Form
- Away From Home Care Services Application
- Conversion Request Form
- IHC dental & vision app
- Bundle New Business Paperwork
- Horizon Dental Waiver
- Small Employer Vision Group Application
- Small Employer Dental Group Application
- Enrollment Change Form
- Statement of Responsibility
- Metlife Binder Check Cover Form
- Group Submission Disclosure Form
- eCensus Format
- 2020 IHC enrollment form
- Payment Form for IHC
- Small Group Master App
- Small Group Enrollment Form
- Small Group Certification
- Small Group EFT form
- Small Group Waiver
- Individual BOR template
- Oxford Verification Form
- NJ Small Group Tax Requirement Instruction Sheet
- Common Ownership Form for Affiliated Groups
- Sweat Equity Program Reimbursement Form
- Authorization for Broker to Act as Benefits Administrator
- Exercise Facility Reimbursement Form
- Health Insurance Claim Form
- HIPAA Member Authorization
- Prescription Drug Reimbursement Claim Form
- NEW- OBM Master Application rev. 9/2018
- UHC Dental & Vision Enrollment Application
- UHC Dental & Vision Master Application
- OBM Small Group Checklist
- OBM dental/vision employee application
- 2020 Renewal Packet
- Midsize NB Checklist
- Small Group NB Checklist
- Members Health Plan Group Termination Form
- Members Health Plan Waiver
- Members Health Plan Renewal Checklist
- Members Health Plan New Business Checklist
- Member Enrollment form for new groups 7/1/19
- Employer Certification effective 7/1/19
- Group Application effective 7/1/19
- Group Plan Selection form effective 7/1/19
- Qualcare Group Termination Form
Claims
Individual
Large Group
Pharmacy
CIGNA
HORIZON
Claims
Individual
Large Group
Small Group
HORIZON ANCILLARY
METLIFE
MIG
OSCAR
OXFORD
Claims
Pharmacy
Small Group
OXFORD ANCILLARY
QUALCARE
USABLE