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*