New Jersey Document Library

New Jersey New Group Documents		Miscellaneous Forms
New Jersey Underwriting Guidelines (PDF) New Jersey Small Group Health Benefits Application (PDF) New Jersey Small Group Certification (PDF) Membership Applications (PDF) Small Group Health Benefits Waiver of Coverage (PDF) Late Paperwork Form (PDF)		CAF 1 (PDF) CAF 4 (PDF) HIPAA Authorization (for claim inquiries) (PDF) Supply Request Form (PDF) New Jersey Domestic Partner Offer Form (PDF) New Jersey Domestic Partner Affidavit (PDF) General Agent Contact List (PDF)
New Jersey Benefit Summaries		New Jersey Benefit Summaries Without Riders
NJ Small Group Plans at a Glance (PDF) NJ State Mandated HMO Plan (PDF) New Jersey State Mandated HMO Copay Plan (PDF) OAP Plan A (PDF) OAP Plan A1 (PDF) OAP Plan C (PDF) OAP Plan D (PDF) OAP Plan E (PDF) OAP Plan F (PDF) OAP Plan G (PDF) OAP Plan J (PDF) OAP Plan K (PDF) OAP Plan L (PDF) OAP Plan M (PDF) OAP Plan N (PDF) OAP Plan O (PDF) Plan A (PDF) Plan B (PDF) Plan C (PDF) Plan D (PDF) Plan E (PDF) OAP Plan Comparison		High Deductible Health Plan (HDHP) 1:90% / 2000 (pdf) High Deductible Health Plan (HDHP) 2:90% / 2500 (pdf) High Deductible Health Plan (HDHP) 3:90% / 3000 (pdf) High Deductible Health Plan (HDHP) 4:100% / 3000 (pdf) Small Group OAP Plan B1 (PDF) Small Group OAP Plan B2 (PDF) Small Group OAP Plan B3 (PDF) Small Group OAP Plan C1 (PDF) Small Group OAP Plan C2 (PDF) Small Group OAP Plan D1 (PDF) Small Group OAP Plan D2 (PDF) Small Group OAP Plan D3 (PDF) Small Group OAP Plan D4 (PDF) Small Group OAP Plan D5 (PDF) Small Group OAP Plan D6 (PDF) Small Group OAP Plan D7 (PDF)