Express Underwriting Request forms.

Express Underwriting Offers Fast Turnaround

Save time with Humana’s Express Underwriting.

Complete and submit Humana’s Express Underwriting Request and other forms to receive a firm risk rate within 48 hours1 on new small business quotes.

Note: You can continue to call Easy Rate at 1-800-327-9728 for baseline quote requests before providing full medical information.

Required Forms

The documents you need to submit for Express Underwriting quote requests are:

  • Express Underwriting Request Form for 2-50 Case Size
    (211 KB) – Download PDF
    English
    Pre-Qualifying Form for 51-99 Case Size
    (211 KB) – Download PDF
    English
  • Census information from your quote
    (Specify census for each location for multi-location employers.)
  • One of the following is needed for Express Underwriting:
    • Humana Employee Applications (Enrollment Form)
    • Other Carrier Employee Applications
    • Approved Agency Questionnaires – Comprehensive, employee-level health assessment (Subject to Humana Underwriting approval)

    One of the following is needed for Pre-Qualifying:
    • Current Carrier Renewal Letter
    • Experience, if available

Submit the forms directly to Easy Rate at the fax or e-mail address in the Express Underwriting Request Form.

1 – Submissions requiring follow-up for additional information may take longer. Final rates subject to change if additional information is received.