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Excellus 2010 Blue Choice HMO Comparison
2010 rates for the Blue Choice Value and Blue Choice 25 plans.
These plans require full underwriting. Please call our office for details.
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Excellus 2010 Group Plan Options
New 2010 plans and rates for BC30-6, BC30-4, SB-C-10, SB-HDHP-10, and HB-HDHP-1. Please note these plans require special underwriting and participation requirements. Please call for details.
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Excellus Authorization (HIPAA disclosure)
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Excellus Group Enrollment / Change Form
Used for all new coverages as well as contract changes.
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Excellus Healthy Blue Application
Use this application to enroll in one of the new Healthy Blue plans through Excellus Blue Cross Blue Shield.
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Excellus Simply Blue PPO SB-C-5 Benefit Summary
This complete benefits summary outlines the SB-C-5 plans available.
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Excellus Underwriting for Employer Groups
Please use this underwriting for Employer Groups when enrolling in a plan within our Bene-Care Association Group
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Excellus Underwriting for Sole Proprietors
Please use this underwriting packet for sole proprietors when enrolling in a plan within our Bene-Care Association Group.
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MVP 2010 HMO Copay Group Plans
New 2010 plans and rates are now available. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP 2010 HMO Copay Sole Proprietor Plans
New 2010 plans and rates for sole propietors. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP 2010 Preferred EPO and HD EPO Group Plans
New 2010 plans and rates are now available. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP 2010 Preferred EPO and HD EPO Sole Proprietor Plans
New 2010 plans and rates for sole propietors. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP 2010 Preferred EPO and TriVantage EPO Sole Proprietor Plans
New 2010 plans and rates for sole propietors. Please note these plans require special underwriting and participation requirements. Please call for details.
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MVP Enrollment Form
Please use this enrollment application when enrolling an employee in an MVP product.
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MVP HMO 25 Benefit Summary
This complete benefits summary outlines the COC-25 plan available through MVP.
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MVP HMO 25-40 Benefit Summary
This complete benefits summary outlines the COC-25/40 plan available through MVP.
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MVP Preferred EPO $25 E0044S Benefit Summary
This complete benefits summary outlines the EPO E044S plan available through MVP.
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MVP Trivantage Reimbursement Form
Used for Lifestyle Reimbursements under the Trivantage Program.
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MVP Underwriting for Employer Groups
These documents must be submitted with all new employer groups applying for MVP Plans.
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MVP Underwriting for Sole Proprietors
All Sole Proprietors enrolling in a MVP Health Care product must complete this underwriting.
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Bene-Care Cancellation Form
Please use this form for all cancellation requests.
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