WPS Health Insurance

Employer Forms

2015 Applications

2014 Applications

For all groups

If your group has less than 100 eligible employees or will be medically underwritten

If you group has more than 50 eligible employees or is experience rated

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New Hire/Change Forms

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Domestic Partnership Forms

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Support Information

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HealthSense Rewards

This discount program rewards your employees for adopting healthy habits and leading healthy lifestyles.

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CMS (Medicare Part D) Information

Updated Guidance and Model Notices: The Centers for Medicare and Medicaid Services (CMS) issued updated creditable coverage guidance and model notices thattook effect January 1, 2009. All updates are related to revisions to the model notices. CMS has decided to eliminate the "Model Personalized Disclosure Notice." Instead, the remaining two model notices include an optional insert that you can complete if you need to provide a personalized notice.

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HIPAA Forms and Documents

This provides a collection of HIPAA forms and documents, particularly those regarding PHI (personal health information).

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