Forms for Agents and Brokers

Visit this page to find all the forms you need to make your job a little easier.

Small Business and Large Group Forms

Application & Enrollment Forms

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

Utah Universal Employee Application (57 KB)

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

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!

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

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


For state-specific marketing materials visit your Group products state page