Employer forms

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

Find health insurance forms and documents below including applications, coverage documents, claim forms, and more that you may need to manage you and your employees' health plan.

Select a category from the list below to view and download the forms you need.

 
Applications and enrollment

  • Add a dependent to my group plan
  • Log into your Sharp Connect account to add dependents for employees who are existing members of Sharp Health Plan.
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  • Online form external link icon

  • Submit a declaration of domestic partnership
  • Employees who are not legally married but wish to add their domestic partner to their plan should fill out this form to see if they qualify.
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  • file icon English (PDF)

  • Add an employee to my group plan
  • Employees who are ready to enroll for coverage will need to fill out this form. You can also enroll an employee online by logging in to your Sharp Connect account.
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  • Online form external link icon  | file icon English (PDF) | file icon Spanish (PDF)

  • Submit a group size attestation
  • Use this form to attest to the size of your employer group.
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  • file icon English (PDF)

  • Request marketing, enrollment or benefit materials
  • Use this form to submit a request for marketing, enrollment, and benefit materials.
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  • Online form external link icon

  • Apply for small group health insurance
  • Use this form to apply for health insurance on behalf of a small employer group (1-100 full-time equivalent employees).
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  • file icon English (PDF)

  • Apply for large group health insurance
  • Use this form to apply for health insurance on behalf of a large employer group with more than 101 full-time equivalent employees.
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  • file icon English (PDF)


 
Benefits and coverage

  • Submit a declination of coverage
  • Employees who currently have coverage through their spouse or a parent can use this form to indicate that they are waiving coverage at this time.
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  • file icon English (PDF)

  • Submit a request for continuity of care
  • Employees can use this form to submit a request to continue receiving medical services with their current health care provider until they complete their care.
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  • file icon English (PDF)


 
Claims

  • Request a deductible credit
  • Use this form to submit a request to Sharp Health Plan for a deductible credit.
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  • file icon English (PDF)

  • Request a reimbursement for medical services
  • Use this form to ask for a refund from Sharp Health Plan for the cost of approved medical services.
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  • file icon English (PDF)

  • Request a reimbursement for prescriptions
  • Use this form to ask for a refund from Sharp Health Plan for the cost of medication you paid for out of pocket.
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  • file icon English (PDF)


 
Manage my plan

  • Submit an authorization to share health information
  • Employees can use this form to give permission to Sharp Health Plan to share their personal health information with someone they choose.
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  • file icon  English (PDF) | file icon Spanish (PDF)

  • Request member ID cards
  • Log in to your Sharp Connect account to request a new ID card for your employees.
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  • Online form external link icon

  • Remove an employee or dependent from my group plan
  • Log in to your Sharp Connect account to terminate an employee from your plan or remove an employee's dependent from your plan.
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  • Online form external link icon

  • Update information for an employee or dependent
  • Log in to your Sharp Connect account to update an employee or their dependent's information such as their name or address.
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  • Online form external link icon

  • Update my business information
  • Log in to your Sharp Connect account to update your contact information such as your email, phone number, or address.
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  • Online form external link icon


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