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Florida Small Business - Forms
North Florida
Groups 2-50
2-50 New Business Enrollment Packet *FILLABLE*
Aggregate Group FAQs
Aggregate Group Form
Binder Check Cover sheet
Common Ownership Form
Employee Application - Spanish
Employer Application
Employer Application Spanish
Group Administrative Change Form
Independent Contractors Paid by 1099 Form
IRS 6055 Subscriber EIN Outbound Template (Needs Excel)
New Business Quote Request Packet
Participation Certification 10+ Eligible Employees
PEO Attestation Form
Prime Enrollment Spreadsheet (Needs Excel)
Scheduled Direct Debit *FILLABLE*
Groups 51-99
51-100 Employee Enrollment Form with Medical Questions
51-100 New Business Enrollment Packet *FILLABLE*
Aggregate Group FAQs
Aggregate Group Form
CNFL 51-100 Enrollment Packet
Common Ownership Form
Employee Application - Spanish
Employee Application with Medical Questionnaire - Spanish
Employer Application
Employer Application - Spanish
Independent Contractors Paid by 1099 Form
IRS 6055 Subscriber EIN Outbound Template (Needs Excel)
Prime Enrollment Spreadsheet (Needs Excel)
Scheduled Direct Debit *FILLABLE*
South Florida
Groups 2-50
Aggregate Group FAQs
Aggregate Group Form
Binder Check Cover Sheet
Common Law Employee Attestation * Effective 10/1/2020 for both New & Renewal Business
Common Ownership Form
Employee Application
Employee Application - Spanish
Employer Application
Employer Application Spanish
Evidence of Insurability Form
Group Administrative Change Form
Independent Contractors paid by 1099
IRS 6055 Subscriber EIN Outbound Template (Needs Excel)
New Business Checklist
New Business Enrollment Packet
New Business Quote Request Packet
Participation Certification 10+ Eligible Employees
PEO Attestation Form
Prime Enrollment Spreadsheet (Needs Excel)
Scheduled Direct Debit *FILLABLE*
Groups 51-99
51-100 New Business Enrollment Packet
Aggregate Group FAQs
Aggregate Group Form
Billing and Collection Agreement
Common Law Employee Attestation * Effective 10/1/2020 for both New & Renewal Business
Common Ownership Form
Employee Application
Employee Application - Spanish
Employee Application with Medical Questionnaire
Employee Application with Medical Questionnaire – Spanish
Employer Application
Employer Application - Spanish
Evidence of Insurability Form
Independent Contractors paid by 1099
Individual Questionnaire
IRS 6055 Subscriber EIN Outbound Template (Need Excel)
New Business Checklist
New Business Enrollment Packet
Prime Enrollment Spreadsheet (Needs Excel)
Scheduled Direct Debit *FILLABLE*