Employers

Why Avera Health Plans?

Learn more about how Avera Health Plans is more than just a health insurance provider.

Resources

• Online Enrollment Login

• Available brochures can help you decide if you want to learn more about what products are available with your health plans.

• Drug formularies for the different tier options available

Employee / Member Forms

• Change Form - Members who enrolled through your employer and want to update your address, phone number or name, please submit to your employer and they will contact Avera Health Plans with your updates.
• Add/Remove Dependents - Members who need to add/remove dependents should fill out this form, and submit to your employer who will contact Avera Health Plans with your updates.
• Coordination of Benefits Form
• Disabled Adult Dependent
• Out-of-Area Residence Form
• Student Verification
• Termination of Coverage Request Form

Small Employer Group Forms (ACA Compliant Plans)

• Application for Small Employer Group Enrollment
• Application for Small and Large Employer Grandfathered and Non-Grandfathered
  
  • Spanish Application
• Employer Participation Agreement Renewal for Small Employer
• Sold Checklist for Small Employer
• Beneficiary Election and Change Form ACA - South Dakota Groups Only

Large Employer Group Forms (ACA and Self-funded Plans)

• Application for Small and Large Employer Grandfathered and Non-Grandfathered
  
  • Spanish Application
• COBRA Services Agreement
• Employer Participation Agreement and Renewal for Large Employer
• Sold Checklist for Large Employer
• Quote Request for Large Employer

Member Resources

• Member Guide - Will provide you available resources for your employees
• Member Benefits - For your group SBC or provider directory, please login to the member portal