Commonly requested resources

RESOURCES

The following documents are commonly requested by our employer clients and TPA or broker partners. Please download the form(s) you need prior to our next steps.

For Third Party Administrators

• ASG Managed Care Network Questionnaire

For Employers & Plan Sponsors

• Individual Health Questionnaire
• Specific Reimbursement
• 50% Notification
• Aggregate Excess Loss
• Eligibility Inquiry
• Premium Statement (.xls)

Other General Resources

• Claims Manual
• HIPAA Compliance

For questions or assistance, please call us at (207) 775-2332 or e-mail us using the form below.