Employer-sponsored plan documents
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2021 Administrative Guide
A booklet to help employers and HR representatives administer their Security Health Plan coverage
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2021 Commercial Member Handbook
A quick-start guide for individual and fully-ensured employer plan members to understand their health plan and find the information they need
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2021 Employer Coverage Customer Guide
A booklet explaining products and perks for employees of a group preparing to enroll in Security Health Plan coverage
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2021 Enrich Overview
A handout sharing information about the Enrich product offering for Dodge County.
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2021 Large Employer Certificate
Provides specific coverage details for your policy
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2021 Transitional Employer Certificate
Provides specific coverage details for your policy
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Automatic Premium Payment Plan Common Questions
A list of common questions and answers for members about setting up an automatic premium payment plan
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Broker quoting checklist
A checklist designed to help brokers organize their quotes
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Care My Way @ Work
A handout for employers with details highlighting Care My Way @ Work
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Care My Way© Brochure
A brochure about our 24-hour Nurse Line and Care My Way© services
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Certificado de Empresa de Transición de 2021
Proporciona detalles de cobertura específicos de su póliza
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Certificado de Empresa Mayor de 2021
Proporciona detalles de cobertura específicos de su póliza
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Domestic Partnership Statement/Enrollment Form
Complete this form to add a domestic partner to your policy
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Employee Health Insurance Application - with medical questionnaire
Employees of new fully insured large employers and new level-funded employers may complete this form to apply for coverage
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Employee Health Insurance Application - without medical questionnaire
Employees of new fully insured small employers and all existing employers may complete this form to apply for coverage
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Employee Health Insurance Election
A document in which employees indicate they are waiving, enrolling in, terminating, or making changes to their health insurance coverage
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Employer Automatic Premium Payment Plan
Information and form for employers about setting up an automatic premium payment plan
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Employer Group Access Request-Security Health Online
Employers should complete this form to get access to Security Health Online
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Employer Group Quote Request
Complete this form if you’d like a quote for your business
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Employer Health Insurance Application
New fully insured large employers and new level-funded employers may complete this form to apply for coverage
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Employer Health Plan Change Request
A form that employers can use to submit a change in demographics, or add domestic partner coverage
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General Capabilities Brochure
Learn about Security’s plans, provider networks and options available for businesses. We have a plan to fit the needs of every employer
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General Capabilities Brochure Flipbook
All the content from the General Capabilities Brochure PDF in a convenient online flipbook format for display purposes
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HIPAA Authorization to Use and Disclose Protected Health Information
Use this form to designate individuals you choose to have access to your health information
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Initial Electronic Enrollment Template
Employers can use this Excel spreadsheet to help organize their enrolled employee’s information
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Initial Electronic Enrollments Employer Guide
A guide to help employers fill out the Initial Electronic Enrollment Template with employee information
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Medication Coverage Options
Learn what drugs are covered with your plan, their cost and network pharmacies
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Member Prescription Drug Reimbursement Request
Complete this form to submit a prescription drug reimbursement claim
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My Security Health Plan Employer Portal Reference Guide
A guide to help you navigate the employer portal
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Premium Contribution Attestation
Complete this form with the percent you pay toward your employees’ premiums
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Renewal Questionnaire
A questionnaire for employers to complete and submit with their renewal paperwork
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Special Enrollment Rights
A notice about special enrollment provisions
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Subscriber Change Request
Complete this form if you have a demographic change, plan change or the addition or deletion of a dependent
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Wellness Brochure
Learn about the wellness programs we offer employers to keep employees healthy and productive