Medical Benefit Change ACA
- Employer Group Application
- Attestation Form
- Sold Quote
- Humana List Enrollment with elections if 2 or more plans
Medical Benefit Change ACA to LFP
- Adobe Sign LFP Contract document
- Sold Quote
- Humana List Enrollment with elections
Medical Benefit Change LFP (to another LFP)
- Employer Group Application
- Sold Quote
- Humana List Enrollment with elections
Ancillary Adds
Dental/Vision
- Group Maintenance Form or Employer Group Application if current KY Chamber medical group
- Sold Quote
- Humana List Enrollment with elections
- Prior carrier bill if electing Implants, Ortho, or under 10 enrolled (dental only)
Life and/or Disability
- Group Maintenance Form or Employer Group Application if current KY Chamber medical group
- Sold Quote
- Humana List Enrollment with elections
- Prior carrier bill
Questions? Contact Tracy.
Direct Phone: 502-400-8575
Agentlink Phone: 502-245-1371 Ext 1207
Fax: 502-400-8575
ttatum@agent-link.net
