Employers

Why Avera Health Plans?

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

Resources

• 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, name, to add/remove a dependent or to cancel your policy, please submit to your employer and they 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

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

• Online 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