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Quote Forms

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Carrier Forms

  • Aetna

    • Aetna AFA Employee Enrollment/Change Form
    • Aetna Employer AFA Form
    • Authorization for Release of Protected Health Information (PHI)
  • Ameritas

    • Application Group Dental and or Eye Care Insurance
    • Enrollment Change Waiver Group Insurance Form
  • Anthem

    • Employee Change Form for Small Groups
    • Employee Enrollment Application for Small Groups
    • Employer Enrollment Application for Small Groups
    • Member Authorization Form
  • Health Plan of Nevada/Sierra Health & Life

    • Authorization for the Release of Protected Health Information
    • Employee Enrollment and Change Form
    • Nevada Small Group Application
    • Non-Plan Provider Claim Form
  • Premier Access

    • Employee Enrollment Change Form
    • Employer Application
  • Prominence

    • Authorization for Disclosure of Protected Health Information
    • Nevada Member Enrollment Change Form
    • Nevada Small Group Master Application
  • United Healthcare

    • Employee Enrollment Form
    • Employer Application for Small Business

Carrier Links

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  • Health Plan of Nevada
  • Premier Access
  • Prominence
  • Sierra Health & Life
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Education/Articles/News

  • About Group Insurance Bill Reconciliation
  • Bill Reconciliation Worksheet
  • Sample Quarterly Tax & Wage

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Sheri@MartinInsuranceLV.com
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