Pink Payroll

Medical Forms | California

Small Group Health

Following are forms for application:

Medical Census - Employee List for Application

Form in Excel

Form in PDF

Broker of Record Change Form

Claim Forms

Aflac Accident Claim Form

Informational Materials

Small Group Underwriting Guidelines (2 to 50 employees)

StartUp Group Guidelines

Large Group Information

51+ Groups Information Gathering Checklist

Pink Payroll Internal Docs

JC LISI Team Contact Info

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Medical Forms | California

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