Self-Funded Forms

• Claim Form - Disability
• Self-Funded Group Enrollment Form

Preferred United Plans "Alternative Funding" Forms

  Michigan

• Request for Proposal
• Employer Application
  
• Employee Health Risk Assessment Application​

  Ohio

• Request for Proposal
  
• Employer Application
• Employee Health Risk Assessment Application​

  Benefit Summaries

• PPO – 100%, 90%, 80% or 70%
  
• HSA – 100% or 80%​

Flexible Spending Forms

• Flexible Spending Claim Form