Get Illinois Small Business Product Selection Form Elite.doc

Completing the Illinois Small Business Product Selection Form Elite.doc online is a crucial step for employers who wish to enroll their employees in UnitedHealthcare Multi-Choice packages. This guide provides clear instructions to help you successfully navigate the form.

Follow the steps to complete the Illinois Small Business Product Selection Form Elite online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering the group name in the designated field. This identifies the business enrolling in the plan.
3. Input the effective date of the plan in the relevant section. This is the date from which the benefits will begin.
4. Specify your employer contribution by choosing either a flat amount or a percentage amount in the appropriate fields.
5. Select the agency’s name and the name of the applicable agent in the respective fields provided.
6. Indicate the benefit plans and Rx options you are providing to employees by selecting the relevant options in the Elite IL002 Benefit Plan Options section.
7. If applicable, include any optional riders such as the vision plan by marking the appropriate box.
8. Ensure that you sign the form at the bottom where prompted, confirming that all the details are correct.
9. Once you have completed the form, you can save any changes you have made, download, print, or share the document as needed.

Take action now by completing your documents online to ensure your business is well-prepared.