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ADVANTAGE Broker Solutions
Broker Forms
Agent Agreement
Assignment of Commission/Agent of Record
Form W-9
Group Forms
Authorization of Health Information Release
Application for Group Policy
Electronic Census Form
Continuity of Care
Enrollment/Change Application
Health Statement
Mail Service Order Form
Step Therapy
Marketing Materials
About ADVANTAGE
ADVANTAGE Brochure
ADVANTAGE FAQ
ADVANTAGE 3-Tier Formulary
ADVANTAGE 4-Tier Formulary
ADVANTAGE Benefit Matrix
ADVANTAGE-Choice Highlights
ADVANTAGE Health Savings Account
ADVANTAGE High Deductible Health Plans Matrix
Care Advantage Brochure
Member Quick Reference
Service Area Map
Tobacco Education
Underwriting Guidelines
Wellness Within
FAQs
Broker FAQ
Errors and Omission Coverage
Hamilton Co. Chamber Plans
Plan Information
Benefit Summaries
HMO 100
HMO 101
HMO 102
HMO 103
HMO 104
HMO 105
HMO 106
HMO 107
HMO 108
HMO 109
HMO F
HMO G
HMO H
HMO J
HMO K
HMO P
HMO Q
HMO R
POS 100
POS 101
POS 102
POS 103
POS 104
POS 105
POS 106
POS 107
POS 108
POS 109
POS L
POS M
POS N
POS P
POS Q
POS R
HDHP 1
HDHP 2
HDHP 3
HDHP 5
HDHP 6
Rider Summaries
Prescription Drugs No Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)
Prescription Drugs $100 Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)
Prescription Drugs $250 Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)
Chiropractic Services
(Please note, Chiropractic Services are not available with High Deductible Health Plans)
Chiropractic Services Rider
Family Planning Services
50% Coinsurance (standard)
HDHP 1
HDHP 2
HDHP 3
HDHP 5
Morbid Obesity
Surgical Treatment for Morbid Obesity Option
Vision
Basic - Exam Plus (standard)
Enhanced - B10
Enhanced - B20
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