Applications and enrollment forms

Get employer applications, employee applications, and other supplemental enrollment forms.

Application and enrollment forms search tool

Please log in to the agent secure portal to order larger quantities or contact your Humana Market Office.

Launch My Group

For the easiest upload option for Humana’s new electronic small group enrollment tool, Launch My Group, use this List Enrollment, Excel.

Helpful tips and tricks for success are located within the User Guide, PDF to ensure you have complete information.

Small business List Enrollment

Submit employee enrollment through our list enrollment spreadsheets. Using list enrollment allows for cases to be enrolled faster, reduces missing information, and provides employers and employees plan information sooner!

For existing small business and new groups submitted with downloaded employer applications:

List Enrollment (Excel spreadsheet), Excel — Use for employer Medical and Specialty benefit plans (Dental, Vision, Life, Disability and Workplace Voluntary products).

List Enrollment User Guide, PDF — Provides an overview of when the List Enrollment can be used and the information that is needed when the list enrollment is used.

Life authorization form

Life authorization form, PDF — This form is required in conjunction with the Evidence of Health Status form when a member is requesting Life coverage over Guarantee Issue.

Small business plan summaries

Download medical plan summaries for products in your area.

Find a plan summary, link opens in new window

Customized client applications

In many states, agents can use our online tool to create customized applications.

Start the application builder, link opens in new window