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  • HOME
  • ABOUT
    • About GBS
    • Leadership Team
    • About AmWINS
    • Careers
      • Job Openings
      • Benefits
      • Application
    • GBS Gives Back
  • PRODUCTS/SERVICES
    • Fully-Insured
      • Individual Health Products
      • Small Group 2-50
      • Mid Market 51-99
      • Large Group 100+
    • Self-Funded
      • Sm. Group - Level Funded
        • Group Underwriting
      • Large Group - Traditional
      • Cost Containment
    • Services
      • FSA/HRA/ICHRA
        • FSA
        • HRA
        • Individual Coverage HRA
      • COBRA/Continuation
      • Enrollment/Billing
      • Online Enrollment
      • Payroll Integration
      • HR Connect/HRIS
      • Continuing Education
      • Broker Outsourcing
      • Cost Containment
  • BROKER/CONSULTANT
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    • COVID-19 Carrier Updates
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    • Individual Health Products
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Forms

Please click each dropdown to view all related forms.

Fully-Insured
Group Application
Enrollment Form
Spanish Employee Election Form (with Addendum)
Small Group Checklist
Small Group Census Template
Confirmation of Full-Time Student Status
Electronic Payment Options
Group Insurance Ineligibility Listing
Small Group Termination Request
Large Group Census Template
Large Group Screening Form
Self-Funded
HealthyAdvantage Checklist
Self-Funding 101
HealthyAdvantage Plan Services Agreement
HealthyAdvantage Cigna Pre-Sale Form
Cigna CWI GBS LifeSource Agreement
Cigna CWI GBS Network Service Agreement
Cigna CWI GBS PBM Agreement
Domestic Partner Affidavit
GBS Health Plans Enrollment Form
GBS Health Plans Late Submission Letter
GBS Health Plans Late Letter to Employees
Medical Claims Form
New York Surcharge Form
Traditional Self-Funded Request for Proposal
Traditional Self-Funded Checklist
Services
HRA Application & ACH Form
HRA Enrollment Form
HRA Reimbursement Form
HRA Premium Reimbursement Form
Premium Reimbursement HRA Group Application
Individual Coverage HRA Group Application
FSA Application & ACH Form
FSA Enrollment Form (All Services)
FSA Enrollment Form (Health & Dependent Care)
FSA Enrollment Form (Health FSA)
FSA Claim Form
FSA Transportation Reimbursement Form
COBRA Administration of Extended Benefits Form
Online Enrollment Agreement
Brokers
Aetna BOR
CareFirst BOR
General Carrier Transfer
Guardian BOR
Hartford BOR
Humana BOR
Lincoln BOR
Single Case Amendment BOR
UHC BOR
Alt
6 North Park Drive, Suite 310
Hunt Valley, MD 21030
Phone: 800.638.6085
Email: sales@gbsio.net

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