Get Universal Group Application For Small Employers - Jl Hubbard ...

This guide provides detailed instructions on how to complete the Universal Group Application For Small Employers - JL Hubbard online. By following these steps, users can ensure that all necessary information is submitted accurately and efficiently, facilitating a smooth application process for health insurance.

Follow the steps to successfully complete the application online.

1. Press the ‘Get Form’ button to access the application form and open it for editing.
2. Begin by filling in the employer information, including the employer name, phone number, and address.
3. Indicate the reason for enrollment by checking the applicable boxes, such as 'New Enrollment' or 'Special Enrollment.'
4. Provide the employment status, noting if the employee is active, a new hire, a retiree, etc.
5. Fill out the employee information section, entering the employee's name, job title, hire date, marital status, and contact details.
6. Move on to coverage requests. Check 'Yes' or 'No' for each family member regarding medical coverage and select plan choices if applicable.
7. Complete the waiver of coverage if applicable, indicating which members are waiving coverage and the reason for the waiver.
8. List all individuals requesting coverage, providing their details such as name, date of birth, gender, and primary care physician.
9. Indicate current or prior coverage information for each individual as specified, including policyholder names and insurer details.
10. If any applicant has Medicare coverage, provide the necessary details related to it.
11. Answer the health statements, responding to questions regarding medical history for each individual applying for coverage.
12. If any 'Yes' answers are given in the health statement section, provide additional information in the designated space.
13. If applicable, fill in additional coverage options available from the employer, such as dental, vision, or disability insurance.
14. Finally, review the acknowledgement and signature section, ensuring all information is accurate before signing and dating the application.

Complete your application online today to ensure you receive the health coverage you need.