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 are simple:

• 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.

More information:

Business Groups of One
Small Groups
Large Groups
Supplemental Plans

Here are the most common service-related forms for Employers.

All Employer Groups

Uniform Employee Application

Uniform Employee Application - Spanish

Employee Enrollment Form - Large Group (51+ Employees)

Employee Enrollment Form - Spanish - Large Group (51+ Employees)

Authorization for Release of Information

Online Disenrollment Form

Pdf Version Disenrollment Form

Change Form

Change Form - Spanish

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 Group Application

Delta Dental Enrollment Form