RESOURCE CENTER

Client Service Forms
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12.03.2012
2013 Submission Deadlines
Horizon releases their submission deadlines for 2013. As a reminder retention changes must be submitted by the 8th prior to anniversary, if not, the next available effective date will be assigned.
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06.22.2012
Enrollment/Waiver Form
Employee enrollment form to be used by an NEW Highmark member, in order to elect/waive Highmark coverage. This is not intended to be used by existing Highmark members to add/change dependents, start/end COBRA, or terminate coverage.
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06.22.2012
Member Change Form (released 5/2012)
Employee enrollment form to be used by an EXISTING Highmark member, in order to add/remove dependents, start/end to COBRA, or terminate their coverage. This is not intended to be used with case installation or new Highmark members.
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