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Products and Providers
Group Dental
Individual Dental
Disability
Individual Life and Disability Income
Travel
 

 

GROUP DENTAL PDF FORMS
American General
Dental available only in OREGON
Employer Paid and Voluntary Dental
Allied National Ins. (AIG American General)
Dental not available in Washington
Employer Paid Dental
• Complete Group Enrollment Kit (OR only)
AIS/Morgan White Group
Underwritten by United HealthCare Ins. Co.
Employer Paid and Voluntary Dental
• Complete Group Enrollment Kit (OR only)
• Complete Group Enrollment Kit (All Other States)
BEST LIFE & Health
Employer Paid & Voluntary Dental

• Complete Group Enrollment Kit – Indemnity Plus (with EE applications)

• Complete Group Enrollment Kit – Indemnity Plus (for use with Enrollment Roster)

• Group Enrollment Roster

Brokers National
Employer Paid & Voluntary Dental
• Complete Group Enrollment Kit (OR only)
• Complete Group Enrollment Kit (WA only)
Companion Life
Employer Paid & Voluntary Dental
Self-funded Dental

• Complete Group Enrollment Kit
(2-9 employees)

• Complete Group Enrollment Kit
(10+ employees)

• Complete Group Enrollment Kit
(Voluntary Only)

Spirit Dental
Direct Benefits (Underwritten by Security Life)
Employer Paid & Voluntary Dental

• Complete Group Enrollment Kit (OR Only)
• Complete Group Enrollment Kit (WA Only)
• Employee Change Form

IHC Health Solutions
Underwritten by Madison National Life Ins. Co.
Employer Paid & Voluntary Dental
Self-funded Dental
• Complete Group Enrollment Kit (OR only)
• Complete Group Enrollment Kit (WA only)
Kansas City Life
Employer Paid & Voluntary Dental

•Complete Group Enrollment Kit ER-Paid
(10+ employees, OR only)

• Complete Group Enrollment Kit Voluntary
(10+ employees, OR only)

• Complete Group Enrollment Kit
(2-9 employees, WA only)

• Complete Group Enrollment Kit ER-Paid
(10+ employees, WA only)

• Complete Group Enrollment Kit Voluntary (10+ employees, WA only)

Reliance Standard Life Ins. Co.
Employer Paid & Voluntary Dental (groups 3-19)
• Complete Group Enrollment Kit
Securian
Employer Paid & Voluntary Dental
Self-funded Dental
• Complete Group Enrollment Kit (OR & WA)
• Employee Change Form
United HealthCare
Confident (TPA Capital Benefits Group)
Employer-Paid & Voluntary Dental

• Complete Group Enrollment Kit (WA only)
• Complete Group Enrollment Kit (OR only)

•Employee Change Form

 
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INDIVIDUAL DENTAL PDF FORMS
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Multiflex Dental
Merchants Benefits Administration
(Underwritten by Nationwide Life Insurance Company)
• Multiflex Brochure and Application – WA only
• Multiflex Brochure and Application – All Other States
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Spirit Dental
Direct Benefits (Underwritten by Security Life)
Individual Dental
Individual Dental for Seniors
• Spirit Individual/Senior Brochure & Application – WA & ID

• Spirit Individual/Senior Brochure & Application – OR & AZ


• Enroll in Spirit Dental
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IHC Health Solutions
Underwritten by Madison National Life Ins. Co.
Individual Dental
• One Life Dental Brochure
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Primestar
Underwritten by Security Life Ins. Co. of America
Personal Dental

Primestar Personal
• Personal Brochure & Application
• Enroll in Primestar Dental

Primestar Classic
• Classic Brochure & Application
• Enroll in Primestar Classic Dental

Primestar Platinum
• Senior Platinum Brochure & Application
• Enroll in Primestar Senior Platinum

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VISION  
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AIG American General
Employer Paid & Voluntary Vision
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AIS
Vision Service Plan (VSP)
Employer Paid & Voluntary Vision (1 life)
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BEST LIFE & Health
Employer Paid & Voluntary Vision
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Brokers National
Employer Paid & Voluntary Vision
 
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GroupLink, Inc.
Employer Paid & Voluntary Vision
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Spirit Vision
Direct Benefits (Underwritten by Security Life)
Employer Paid & Voluntary
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United HealthCare
Confident (TPA Capital Benefits Group)
Voluntary Vision
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AIS/Morgan White Group
Spectera Employer Paid & Voluntary Vision
 
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Companion Life
Employer Paid & Voluntary Vision (OR only)
 
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DISABILITY  
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AIG American General
Employer Paid & Voluntary STD
Employer Paid & Voluntary LTD
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Allied National Ins. (AIG American General)
Employer Paid STD and LTD
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Companion Life
Employer Paid & Voluntary STD
Employer Paid & Voluntary LTD
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Kansas City Life
Employer Paid & Voluntary STD
Employer Paid & Voluntary LTD
 
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Reliance Standard Life Ins. Co.
Employer Paid STD (2-19 lives)
Employer Paid LTD (2-19 lives)
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United Heritage
Employer Paid & Voluntary STD
Employer Paid & Voluntary LTD
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GROUP LIFE  
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AIG American General
Employer Paid & Voluntary Life/AD&D
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Allied National Ins. (AIG American General)
Employer Paid Life/AD&D
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Companion Life
Employer Paid & Voluntary Life/AD&D
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Kansas City Life
Employer Paid & Voluntary Life/AD&D
 
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Reliance Standard Life Ins. Co.
Employer Paid Life/AD&D (2-19 lives)
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United Heritage
Employer Paid & Voluntary Life/AD&D
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INDIVIDUAL LIFE AND DISABILITY INCOME  
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AIG American General
Term Life, Universal Life
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American National Ins. Co.
Term Life, Universal Life, Whole Life
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Assurity Life Ins. Co.
Disability Income, Term Life,
Universal Life, Simplified Life
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Banner Life
Term Life, Universal Life
 
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Old Mutual
Term Life, Universal Life
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Genworth Life Ins. Co.
Term Life, Universal Life
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RBC Insurance (Liberty Life Ins. Co.)
Term Life, Internet Term Life
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Mass Mutual
Disability Income, Term Life,
Universal Life, Whole Life
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Mutual of Omaha
Term Life, Universal Life
 
Transamerica Occidental Life
Term Life, Universal Life
 
West Coast Life
Term Life, Universal Life, Whole Life
 
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MEDICAL  
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AIG American General
(Oregon only)
Short Term Medical
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Assurant Health
Short Term Medical
• Enroll in Assurant Short Term Medical. Click here to sign up.
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Health Plan Administrators
(Oregon only)
Short Term Medical
 
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International Medical Group, Inc.
Patriot Travel Medical Insurance
and Global Medical Insurance
IMG's SelectaPlan:
Brochures and Coverage Information
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Mutual of Omaha
Medicare Supplement
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Seniors Choice
Merchants Benefit Administration
(Underwritten by Guarantee Trust Life)
Group Retiree Medical
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TRAVEL  
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Travel Medical Insurance

International Medical Group, Inc.
Patriot Travel Medical Insurance
and Global Medical Insurance

Perform an IMG Online Transaction

IMG's SelectaPlan:
Brochures and Coverage Information

Travel Guide from TripResource.com
Travel Guide specializing in International travel information and International travel guides. Find links to travel resources: rental cars, airfare, lodging, cruises and more.

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Online Applications:

Patriot T.R.I.P.® Travel Insurance

Patriot T.R.I.P.® Elite Travel Insurance

Patriot T.R.I.P.® Student

Patriot Extreme®

Patriot Group® Standard

Patriot Exchange ProgramSM

Patriot Group Exchange ProgramSM

Student Health AdvantageSM

Plan PDF Brochures and Applications:

Patriot Travel Medical Insurance

Patriot Group

Patriot Extreme

Patriot Executive

Patriot Executive Group

Patriot T.R.I.P.

Patriot T.R.I.P. Elite

Patriot T.R.I.P. Student

Global Medical Insurance Application

Global Medical Insurance Brochure

GEO Group Request for Proposal

Student Health Advantage

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