Enrollment.healthcomp.com

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HealthComp – Health Benefits Administrator

WEBWe are the largest, privately-held third-party administrator (TPA) committed to providing customized, innovative, affordable healthcare. We envision HealthComp as a leading …

Actived: 3 days ago

URL: http://enrollment.healthcomp.com/

HealthComp Online

WEB1. Welcome to HCOnline. HCOnline is a web-enabled application allowing interactive access to eligibility, claims history and other plan specific information via the Internet. …

Category:  Health Go Health

FLEXIBLE BENEFITS PLAN

WEBPlease review your Summary Plan Description for your run-out period. √Send Claim to: HEALTHCOMP, P. O. Box 45018, Fresno, CA 93718-5018 or Fax to: Flexible Benefits …

Category:  Health Go Health

FLEXIBLE BENEFITS ENROLLMENT/CHANGE FORM

WEBFLEXIBLE BENEFITS ENROLLMENT/CHANGE FORM Mail to: HealthComp, Inc. P. O. Box 45018, Fresno, CA 93718-5018 (559) 499-2450 or (800) 442-7247 Fax (559)499 …

Category:  Health Go Health

Group Medical Claim Form-Fresno vs.2

WEBGROUP MEDICAL CLAIM FORM. SUBMIT CLAIMS TO: P.O. BOX 45018, FRESNO, CA 93718-5018 Phone: (800) 442-7247. Fax: (559) 499-2464. Email: …

Category:  Medical Go Health

ACCIDENTAL INJURY QUESTIONNAIRE

WEB2 (8) Do you or the patient have any other insurance policy which you believe may be responsible to pay for any expenses related to this injury?

Category:  Health Go Health

Request for Information Do you have a Certificate of …

WEBDate _____/_____/_____ Patient: _____ Group No: _____ Employee: _____ Acct No: _____

Category:  Health Go Health

Other Insurance Questionnaire

WEBIf no, sign and date at the bottom and return this form to HealthComp. If yes, please provide relevant information for each additional Carrier/Plan providing other health insurance …

Category:  Health Go Health

PART 1 EMPLOYEE INFORMATION EMPLOYER PLAN CHOICE …

WEBGROUP ENROLLMENT/CHANGE FORM New Enrollment Name/Address Change Reinstatement Rehire Annual Enrollment Change Enrollment Decline Coverage …

Category:  Health Go Health

AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH …

WEBAUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION MEMBER’S NAME: _____ MEMBER I.D. NO.: _____ I authorize the use and disclosure of my …

Category:  Health Go Health

EMPLOYEE INFORMATION IF CLAIM FOR DEPEN DENT, …

WEBGROUP VISION CLAIM FORM SUBMIT CLAIMS TO: P.O. BOX 45018 • FRESNO, CA 93718-5018 • (800) 442-7247 1. Your Policy and/or Group number(s) 2.

Category:  Health Go Health

PART 1 EMPLOYEE INFORMATION EMPLOYER FOR …

WEBName/Address Change HRA ENROLLMENT/CHANGE FORM Annual Enrollment New Enrollment Change Enrollment Decline Coverage Termination P.O. BOX 45018, …

Category:  Health Go Health

Date: From: Facility Provider Ext: Fax: ZIP: Worker's Comp

WEBTitle: Microsoft Word - Precert Final Online Form 7 09 2013 - Copy.doc Author: scotto Created Date: 11/19/2014 10:31:40 AM

Category:  Health Go Health

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