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Small Business Group Acceptance/Change Form Effective July 1, 2007, Source Code Please indicate reason for change: New Business: Acceptance of new coverage Renewals: Acceptance of renewal with new

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What is change existing coverage group?

Change existing coverage group is a form used to update information about the coverage group.

Who is required to file change existing coverage group?

Employers or plan administrators are required to file change existing coverage group.

How to fill out change existing coverage group?

You can fill out change existing coverage group online or by mail.

What is the purpose of change existing coverage group?

The purpose of change existing coverage group is to ensure accurate reporting of coverage information.

What information must be reported on change existing coverage group?

Information such as plan changes, coverage start and end dates, and participant details must be reported on change existing coverage group.

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