"At a Glance"

• Innova
  • Product Page
  • Plan Highlights

Cross-Selling

Bundle Innova with these products for potential benefit savings:

• Vitality Wellness Product (Available to groups 100+)
• Dental Plans: Encore^SM, Expressions^SM & Radiance^SM
• Vision Plans
• Life & Disability: Regence Life & Health
• Employee Assistance Program

Quoting

Generate an online quote for groups of 2-50 employees. For larger groups, contact your Sales Executive.

• Start a Quote (Groups 2-50)

Your Presentation

• Logo guidelines
• Innova Employer Collateral
• Product Brochure
  Provides an overview of the Innova product. The brochure has a capacity pocket in the back that can hold additional collateral such as the detailed product benefit summaries.
  
  Finished size 9" x 12". 16 pages + capacity pocket, 4-color process.
• Product Flyer/Renewal Flyer
  Provides a high-level overview of Innova's features and benefits.
  
  Finished size 8-1/2" x 11". 2 pages, double-sided, 4-color process.
• Order from your Sales representative

Forms

Group Forms

• Group Proposal Request (Groups 2-99)
• Spreadsheet Enrollment Procedure and Template (Groups 100+)

Enrollment Applications

• Small Employer Application (Groups 2-50) (PDF)
• Application for Enrollment/Change (Groups 51-99)
• Application for Enrollment/Change (Groups 100+ Fully Insured)
• Application for Enrollment/Change (Groups 100+ Self Insured)

Waiver Forms

• Waiver Form (Group Size 51+) (PDF)

Guides, Checklists & Forms

• Spreadsheet Enrollment Procedure and Template (Groups 100+)
• Innova Group Administrator Manual (PDF)
  This guide answers general questions about enrollment, billing, and appeals procedures.
• Online Enrollment Set-Up Checklist (PDF)
• Group Master Applications - Effective for groups with effective dates of 1/1/2012 and beyond
  • Groups 2-99 Employees (Fillable PDF)
  • Groups 100+ Fully Insured (Fillable PDF)
  • Groups 100+ Self Insured (Fillable PDF)
• Surepay Authorization Form (PDF)

Employee Forms

• Small Employer Application (Group Size 2-50) (PDF)
• Application for Enrollment/Change (Groups 51-99) (Fillable PDF)
• Application for Enrollment/Change (Groups 100+ Fully Insured)
• Application for Enrollment/Change (Groups 100+ Self Insured)
• Waiver Forms
• Waiver Form (Group Size 51+) (PDF)
• Affidavit of Qualifying Domestic Partnership (PDF)
• Affidavit of Qualifying Incapacitated Dependent Eligibility (PDF)

Employee Materials

• Member Materials: myRegence.com brochure, pharmacy flyers & brochures, wellness program flyers. Many available in Spanish. Order from your Sales representative
• Open Enrollment DVD (in Spanish): explains the importance of health care. Order from your Sales representative
• Innova Plan Highlights
• Effective January 1, 2012 and Beyond (PDF)