Updated Applications & Key Open Enrollment Dates
Updated Applications are Available Online
We have standardized our applications to ensure consistency and quality in your member enrollment
changes. Please note that the standard applications are the only applications approved for member
enrollment and should be used in association with standard product offerings. Not using these
applications could result in membership delays.
View updated applications >>
Important: Submission Timeline
- To ensure ID card release by 1/1/13, final submission date for paper enrollment for brokers and groups is 12/1/12. All supporting group documentation needs to be complete and accurate.
- Renewals and new group paperwork will be accepted through 12/30/12 for a 1/1/13 effective date. New group enrollment received after 12/30/12 will have a 2/1/13 effective date.
- For Medicare Advantage and Medicare Stand Alone Part D products, enrollment will be accepted up to 12/15/12 for a 01/01/13 effective date. After 12/15/12, the effective date will be 2/1/13.
If you have any questions, please contact your Account Consultant.