Get the free CaliforniaChoice Employer Application (CC 0201)

721 South Parker, Suite 200 Orange, CA 92868 www.calchoice.com Please complete using black ink or typewriter. Return signed and completed application and those of employees to your broker. Employer

How to fill out californiachoice employer application cc

How to fill out californiachoice employer application cc:

1. Start by obtaining the californiachoice employer application cc form. You can typically find this form online on the official website of californiachoice or by contacting their customer service.
2. Begin filling out the form by providing your company's basic information, such as the name, address, and phone number.
3. Next, you will need to enter the contact information of the person responsible for administering the company's health benefits, including their name, title, phone number, and email address.
4. Indicate the type of business your company is involved in and the number of employees it has. Include details about any subsidiary companies, if applicable.
5. Specify the requested effective date for the health benefits plan.
6. Provide financial details, such as the estimated monthly premium for the group, the employer contribution towards the premium, and the maximum annual deductible for employees.
7. If your company offers multiple plans, select the desired plan options from the choices provided in the application.
8. Fill in the requested information regarding the company's previous carrier, if applicable.
9. Indicate whether your company is interested in adding any of the additional benefits offered by californiachoice, such as dental, vision, or life insurance.
10. Sign and date the application, and ensure that all required fields have been completed accurately.
11. Submit the application to californiachoice through the designated submission method, which could be via mail, fax, or online portal.

Who needs californiachoice employer application cc:

1. Employers in California who wish to provide health benefits to their employees through californiachoice are required to fill out the employer application cc form.
2. Small businesses looking for a comprehensive and customizable health benefits solution can benefit from californiachoice.
3. Companies seeking to provide their employees with a variety of health plan options from different carriers will find value in using californiachoice.
4. Employers who want access to additional benefits such as dental, vision, and life insurance can also benefit from filling out the californiachoice employer application cc.

For pdfFiller’s FAQs

What is californiachoice employer application cc?

Californiachoice employer application cc is a form used by employers to apply for health insurance coverage through the CaliforniaChoice program.

Who is required to file californiachoice employer application cc?

Employers who want to provide health insurance coverage through the CaliforniaChoice program for their employees are required to file the californiachoice employer application cc.

How to fill out californiachoice employer application cc?

The californiachoice employer application cc can be filled out online or through a paper form provided by CaliforniaChoice. Employers must provide information about their company, the number of employees, and desired coverage options.

What is the purpose of californiachoice employer application cc?

The purpose of californiachoice employer application cc is to enroll employers in the CaliforniaChoice program and provide health insurance coverage options for their employees.

What information must be reported on californiachoice employer application cc?

On the californiachoice employer application cc, employers must report information about their company, including the number of employees, desired coverage options, and contact information.

How do I edit californiachoice employer application cc online?

pdfFiller not only allows you to edit the content of your files but fully rearrange them by changing the number and sequence of pages. Upload your californiachoice employer application cc to the editor and make any required adjustments in a couple of clicks. The editor enables you to blackout, type, and erase text in PDFs, add images, sticky notes and text boxes, and much more.

How do I make edits in californiachoice employer application cc without leaving Chrome?

Get and add pdfFiller Google Chrome Extension to your browser to edit, fill out and eSign your californiachoice employer application cc, which you can open in the editor directly from a Google search page in just one click. Execute your fillable documents from any internet-connected device without leaving Chrome.

Can I create an electronic signature for signing my californiachoice employer application cc in Gmail?

You can easily create your eSignature with pdfFiller and then eSign your californiachoice employer application cc directly from your inbox with the help of pdfFiller’s add-on for Gmail. Please note that you must register for an account in order to save your signatures and signed documents.