Follow the steps to fill out the Sutter Health Plus E-19-061 application.

1. Press the ‘Get Form’ button to retrieve the application form and open it for editing.
2. Begin by filling out the legal company name and the DBA (Doing Business As) name, if applicable, in the designated fields. Specify the requested effective date for health coverage.
3. Proceed to Section A and select your preferred benefit plan from the options listed under both the standard plans and plus plans. Make sure to review the details carefully to choose the most suitable plan.
4. In Section A3, indicate any subaccounts relevant to your application. If additional subaccounts are necessary, fill them in accordingly.
5. Fill out Section A4 to select any optional benefits you would like, such as dental, vision, or acupuncture services. You can choose to decline any optional benefits if preferred.
6. Move to Section B and fill in group information, which includes the legal company name, address, Federal Employer ID Number, and contact details. Ensure that addresses are complete and in the required format.
7. Complete the employee eligibility section, detailing the number of eligible employees and participation levels. This includes information on total employee participation and any employees waiving coverage.
8. If applicable, fill out Section C with broker information. This includes providing details such as the broker/agent name and license information.
9. In Section D, you will need to provide information regarding initial and subsequent premium payments. Include necessary details about the payment method and whom to contact for questions.
10. Finally, review the Employer Agreement in Section E and sign the application. Ensure that all information is accurate before submission.
11. Once all fields are completed, save your changes, and you may download, print, or share the completed form directly from your device.

Complete your Sutter Health Plus E-19-061 application online today for a seamless experience.