Employer forms

These commonly requested forms are provided to assist you in managing your employees' enrollment with Sharp Health Plan.

Correction to group statement

Use this form to report adjustments to your monthly statements.

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Large group master application

Thanks for choosing us. We’re glad you’re ready to get your group covered with us. First, we’ll need some information about your company, employee eligibility, and your plan preferences. Then, we can start getting your group the care they need.

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Small group master application

We’re excited that after all the shopping around and research you’ve done, your group wants to partner up with us. Before we get started, we’ll need you to fill out this master application. Once it’s complete, send it over and we’ll take it from there.

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We're here to support you in any way we can. Contact us with your questions.

Share your health information with loved ones

At some point during your care, you may want us to disclose your protected health information to someone else, like a partner or child. Here you’ll find the form you’ll need to authorize the release of that information.

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Declination of coverage

Maybe an employee has coverage through their spouse or a parent and doesn’t want coverage right now, that’s okay. If they change their mind, have them fill out this form, indicating that they are waiving coverage at this time.

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Declaration of domestic partnership

Even if a member and their partner are not legally married, they may still qualify for benefits. Have them fill out this form declaring their domestic partnership to see if they’re eligible. 

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Enrolling employees

When employees are ready to start getting coverage, they’ll need to fill out this form. This helps us organize and keep track of their benefits so that they can maximize their coverage and care.

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Enrolling employees (Spanish)

Here's the employee enrollment form for our Spanish-speaking members.

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Get reimbursed for medical services

If you're looking to be reimbursed for eligible out-of-pocket medical expenses, be sure to submit this reimbursement request form within 180 days of the date of service.

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Get reimbursed for your prescription drugs

If your doctor has prescribed a medication you’ve purchased from a pharmacy within the last 180 days, then you might be eligible for a reimbursement. Find out if you qualify and learn how to submit a request.

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Request continuity of care benefits

To help your healthcare providers coordinate the best possible care for you, you can authorize your medical information and history to be integrated into one place that your providers can easily access. See how continuity of care benefits can improve your overall health care experience.

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Not finding what you’re looking for?

Let’s talk. Call us at 1.800.359.2002 or send us a message

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