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WYOMING SMALL GROUP APPLICATION (2 50) 10421 South Jordan Gateway, Suite 400 South Jordan, UT 84095 Important: Please type or print all sections in ink. Employer or designee must complete and sign
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Review the completed application form once again to ensure all the information provided is correct and complete. Make any necessary changes or additions if required.
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If there is an option to submit the application form online, follow the specified instructions to do so. Otherwise, if a physical copy is required, ensure all the pages are properly stapled or organized and submit it to the designated office or individual.
Who needs small group application 2:
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Students applying for enrollment in a specific small group or program within an educational institution.
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What is small group application 2?
Small group application 2 is a form used to apply for small group health insurance coverage.
Who is required to file small group application 2?
Employers with a small group of employees who are seeking health insurance coverage.
How to fill out small group application 2?
Small group application 2 can be filled out online or manually by providing information about the employer, employees, and desired health insurance coverage.
What is the purpose of small group application 2?
The purpose of small group application 2 is to apply for health insurance coverage for a small group of employees.
What information must be reported on small group application 2?
Information about the employer, employees, and desired health insurance coverage must be reported on small group application 2.
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