FORMS
Here are some of the commonly used insurance company and Rigby Group Benifits forms.To read these files, you will need Adobe
Acrobat Reader, which you can obtain for no cost at
http://www.adobe.com.
Simply print out the forms you need.
INSURANCE
COMPANY FORMS
Aetna
• Employee
Application/Change Form
American
Medical Security
• Employee Application
• Request to Modify
BlueCross/BlueShield
of Illinois
• Employee
Application
• Enrollment Change Request
Guardian/First
Commonwealth
• Dental Employee
Enrollment Card
Humana
• Employee
Application/Change Form
• Non-Medical
Employee Application Form
• Request to Modify the Employer Group Application
MetLife
Dental
• Employee Application
United
HealthCare
• Employee Application (Groups 2-25)
• Employee Application (Groups 26-50)
RIGBY
GROUP BENEFITS FORMS
Claim
Resolution Form
Census Form
Group Health
Insurance Quote Form
Life Insurance Quote Form
Claim
Resolution Form
Let
us handle your claim problem. Simply:
1. Download
the Claim Resolution
Form.
2. Complete the form.
3. Attach your bill and any other pertinent information.
4. Fax it to us at 630-236-7301.
As soon
as we receive your Claim Resolution Form, we will contact
the insurance company and/or provider and get to work
on resolving your claim.
Also, check
out our "How
To Avoid Claim Problems" section. You can eliminate
some potential claim problems by following these simple
guidelines.
Census
Form
If you'd like to get a head start on your renewal, print out and complete the Census Form and fax it to us.
If you would rather wait for us to initiate the renewal
process, don't worry. We'll contact you in plenty of
time to request the information we need for your renewal.
Group
Health Insurance Quote Form
If you're looking for group insurance for your company
and you would like a quote, print out and complete the Group Health Insurance Quote and Census forms, and fax it to us. We will get quotes and generate
your personalized Health Comparison Report.
Life
Insurance Quote Form
For a no obligation life insurance quote, print out and
complete the Life Insurance Quote Form, and then fax the
it to us. We will research
the cost of life insurance from over 200 life insurance
companies and send the best selections to you. |
