Health America
2015 enrollment-change form
2015 Hapa group app
Employee Termination Report
HAP Rx List 2015
RX Claim Form
Highmark
2015 HBC Individual Application
2015 Small Group Business Application
Balance Blue PPO 500 Community Blue Flex
Balance Blue PPO 1000 Community Blue Flex
Balance PPO $1000 A
Comm Blue Flex Brochure
Comp Care PPO 500
Comp Care PPO 1500
Designer Advantage Option I
EFT Application
Fashion Advantage Gold Option I
Fashion Advantage Gold Option V
Fashion Advantage Option I
Fashion Advantage Option V
Flex Blue Penn Highlands PPO 1200
Flex Blue PPO 1200 PA Mountains Community Blue
HBC Enrollment_Waiver form ENR-121(R9-14)
HBC Group Term
HBC Member Change Form 2015
Health Savings Blue PPO 2750 Community Blue
Individual Change Form
January 2015 to December 2015 vision rates
July 2015-Dec 2015 2-99 Dental Rates
July 2015-Dec 2015 51-99 Dental Rates
Maj Event PPO 6600
Premier Balance PPO $0 Platinum A
Premier Balance PPO $250 Gold A
Premier Balance PPO $250 Platinum A
Premier Balance PPO $500 A
Premier Balance PPO $1000 A
Premier Balance PPO $1250 A
Premier Balance PPO $1400 A
Premier Balance PPO $1500 A
Premier Balance PPO $1500 IP A
Premier Balance PPO $2000 A
Premier Balance PPO $2500 A
Premier Balance PPO $3500 A
Premier Balance PPO 250 IP A Community Blue Flex
Shared Cost 3200
Shared Cost PPO 1000 Community Blue Flex
Shared Cost PPO 1200 Community Blue Flex
Shared Cost PPO 1500
Shared Cost PPO 2100 Community Blue Flex
Shared Cost PPO 2650 Community Blue Flex
Shared Cost PPO 5500 Community Blue Flex
Shared Cost PPO 5500
Special Enrollment Period Form
UCCI
Enrollment Form
Group Application
UPMC
14SAM0100-Employee-Benefit-Election–Change-Form-FINAL
2015 Network Guide
Bronze 6000 Select
Bronze 6000-25 Partner
Gold 500-15 Prem Network
Gold 750-10 Prem Network
Gold 750-10 Select Network
Group Application
OFF EXCHNG APP V8
Platinum 250-20 Prem Network
Silver 0-50 Prem Network
Silver 1750-30 Prem Network
Term Group Form
Updated UPMC membership termination form 5_13_2014
UPMC Partner Network
UPMC Premium Network
UPMC Standard Network 2015