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Helpful information for small group clients

Product portfolios and brochures

2023 ACA Small Group Product Portfolio

2023 Together Blue Brochure

2023 ACA Small Group Benefit Changes Brochure

2022-2023 Grandmothered Small Group Policy Options

2023 Small Group Pediatric Dental and Vision Brochure

2023 Preventive Schedule

Blue Edge Vision Plans (2023)

Blue Edge Dental Rate Card 2-9 (January-June 2023)

Blue Edge Dental Rate Card 2-50 (January-June 2023)

Blue Edge Dental Rate Card 2-9, Rating Region 1 (January-June 2023)

Blue Edge Dental Rate Card 2-50, Rating Region 1 (January-June 2023)

Blue Edge Dental Rate Card 2-9 (July-December 2023)

Blue Edge Dental Rate Card 2-50 (July-December 2023)

Blue Edge Dental Rate Card 10-50 (July-December 2023)

Blue Edge Dental Rate Card 2-9, Rating Region 1 (July-December 2023)

Blue Edge Dental Rate Card 2-50, Rating Region 1 (July-December 2023)

Blue Edge Dental Rate Card 10-50, Rating Region 1 (July-December 2023)

Forms and checklists

Small Group Sold Checklist

HSA Application

Underwriting Guidelines

Small Group Business Application (2023)

Enrollment/Waiver Form (2023)

Enrollment Spreadsheet

Member Change Form

Authorization to Cancel Highmark Small Business Coverage

General Update Changes for Small Group

Start-Up Business Affidavit

Disability Verification Form

Disabled Dependent Certification

Affidavit of Common Law Marriage

Act 4 Dependent Verification Form

Domestic Partner Affidavit

New Employee Affidavit

Certification of Eligibility to Combine and Employer Group Size

Client Change Letter of Explanation (Template) Checklist

Additional resources

Small Group Client Admin Guide

Together Blue OE Access Brochure with Map

2023 Quarter 1 Rates for Western Pennsylvania

Employer HSA Contribution and Funding Guide

Member HSA Guide