Highmark | Small Group Update: Revisions to the Northeastern Pa Small Group Checklist Now Available

REVISIONS TO SMALL GROUP CHECKLIST NOW AVAILABLE!

Effective July 1, 2020, you should begin utilizing the newly revised Small Group forms.

Updated forms include:

Act 4
Authorization to Cancel Highmark Small Business Coverage
Certification of Eligibility to Combine and Employer Group Size
Client Letter Template
Disability Verification form
Domestic Partner Affidavit
General Updates for Small Group Form
Highmark Enrollment/Waiver Form
Small Group Business Application
Sold Group Checklist

You can view a more detailed version of the revisions, here.

You can access the new northeastern Pa Small Group Checklist here.

If you have any questions, please contact your Highmark Small Group Sales Executive or Client Manager.

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Insurance and/or benefit administration may be provided by Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, all of which are independent licensees of the Blue Cross and Blue Shield Association.

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