Tools and Forms
Working together, we can make the application process seamless and efficient for the benefit of our mutual customers. Here you will find information on the application process along with the forms necessary to successfully submit your commercial group to RMHP.
The key to a successful submission of a new group application is simple:
More information: Small Groups Large Groups Supplemental Plans
- Refer to the New Group Checklist to ensure all steps are completed.
- Be sure to include all required documentation with your submission.
- Participate actively with your RMHP Account Executive.
Here are the most common service-related forms for Employers.
All Employer Groups
Uniform Employee Application English
Small Group HMO Application for Health Benefits (2016) English
Small Group HCO Application for Health Benefits (2016) English
| Español Authorization for Release of Information English | Español Online Disenrollment Form
Pdf Version Disenrollment Form English
Group Change Form English
Employee Change Form English Notice of Qualifying Event Form COBRA/CCOC
Electronic Funds Transfer for Employer Groups
Request for Enrollment of Common Law Spouse
Request for Enrollment of a Disabled Dependent Newborn Coverage Waiver VSP Member Enrollment Form
Delta Dental Enrollment Form English
Small Group Underwriting Guidelines
Delta Dental Application Administrative Guide for Employers