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For Agents: Group Products, Medical Carriers

Highmark Health Insurance Company (HHIC)

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Underwriting Guidelines | Enrollment Forms | Miscellaneous Forms | Product Grids


Underwriting Guidelines

Underwriting Process Guide / Checklist
02/03/12

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Enrollment Forms

Checklist
07/28/10
Employer Application
08/11/11
Employee Application
08/11/11

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Miscellaneous Forms

General Update/Change
02/03/12
Group Cancellation Form
02/10/11
HRA Small Group Setup Form
05/04/10
2012 Product Portfolio
02/03/12
Sample Agent of Record
01/13/11

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Product Grids

Premium Plans
PPOBlue $10
11/11/11
PPOBlue $20
11/11/11
PPOBlue $20-$40
11/11/11

Take Charge Plans
PPOBlue 90/70
11/11/11
PPOBlue $250 90/70
11/11/11
PPOBlue $250 80/60
11/11/11

Sharing Plans
PPOBlue $250
11/11/11
PPOBlue $500
11/11/11
PPOBlue $750
11/11/11
PPOBlue $1000
11/11/11
PPOBlue $1250
11/11/11
PPOBlue $1500
11/11/11
PPOBlue $2000
11/11/11
PPOBlue $2500
11/11/11
PPOBlue $3000
11/11/11

Smart Plans
PPOBlue $500 90/70
11/11/11
PPOBlue $500 80/60
11/11/11
PPOBlue $750 90/70
11/11/11
PPOBlue $1000 80/60
11/11/11
PPOBlue $1250 90/70
11/11/11

Family Savings Plans
PPOBlue $3000C 90/70
11/11/11
PPOBlue $4000C
11/11/11

Healthy Savings Plans
PPOBlue $1250Q
11/11/11
PPOBlue $1500Q
11/11/11
PPOBlue $2000Q
11/11/11
PPOBlue $2600Q
11/11/11
PPOBlue $2600Q 90/70
11/11/11
PPOBlue $3500Q 90/70
11/11/11

All the above listed grids have Highmark's Incentive ($8/$35/$50) Formulary. For a summary of Highmark's prescription drug options, please click here. If you would like benefit grids with alternative Rx options, please contact our office or download all grids by using the link below.

Highmark Dental & Vision information can be found on the "Carrier-Branded Products" page of the Ancillary Products.

Download all HHIC Product Grids (ZIP)


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