Forms Authorization Agreement For Recurring Direct Payments (ACH Debits) This resource is intended for: EmployeesEmployersRetirees
SHARP (Less Than 65 with Medicare) 2024 Summary of Benefit and Coverage (SBC) Base Option This resource is intended for: EmployersEmployeesRetirees
SHARP (Less Than 65 with Medicare) 2024 Enrollment Form This resource is intended for: EmployeesEmployersRetirees
SHARP (Less Than 65 with Medicare) 2024 Plan Document This resource is intended for: EmployeesEmployersRetirees
Pre-Medicare SHARP (Less Than 65)SHARP (Less Than 65 with Medicare) Notice of Privacy Practices This resource is intended for: EmployeesEmployersRetirees
Pre-Medicare SHARP (Less Than 65) 2024 Summary of Benefits – High Deductible Plan This resource is intended for: EmployeesEmployersRetirees
Pre-Medicare SHARP (Less Than 65) 2024 Summary of Benefits – Low Deductible Plan This resource is intended for: EmployersEmployeesRetirees
Pre-Medicare SHARP (Less Than 65) 2024 Enrollment Form This resource is intended for: EmployeesEmployersRetirees
Pre-Medicare SHARP (Less Than 65) 2024 Plan Document This resource is intended for: EmployeesEmployersRetirees
WebTPA Claims ProcessingFormsSHARP-Ex (65 Plus)Pre-Medicare SHARP (Less Than 65)SHARP (Less Than 65 with Medicare)SHARP Dental, Vision, Hearing WebTPA Claim Form This resource is intended for: EmployeesEmployersRetirees