Commonly requested 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.

 

 

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