Applications and Enrollment forms
Get employer applications, employee applications, and other supplemental enrollment forms.
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 , opens in new window.
Helpful tips and tricks for success are located within the , PDF opens in new window 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:
, excel opens in new window — Use for employer Medical and Specialty benefit plans (Dental, Vision, Life, Disability and Workplace Voluntary products).
, PDF opens in new window — 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
, PDF opens in new window — 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.
Customized client applications
In many states, agents can use our online tool to create customized applications.