Return to Univera Employers News

Plan Designation Indemnification Is Now A Fillable Form

We’re excited to share the availability of a fillable Plan Designation Indemnification form. This has been a request from brokers and self-insured groups that use the form, and we look forward to this new form saving time for everyone.

The fillable versions of these forms can be requested from your account representative. Once it is received, it can be opened in Adobe, completed, and electronically signed. Groups can still print these forms, fill them out, sign, and scan back to us if they prefer.

Please note:

  • Any saved copies of these forms need to be deleted, including any fillable versions that you or your team created on your own.
  • We will only accept our version of a fillable form so we can maintain the validity of the content and obtain an acceptable and consistent electronic signature.
  • The forms must be opened in Adobe and not opened in a browser, as the browser will not allow you to sign the form.
  • Once signed, the documents will lock to any additional edits, so be sure the form is completed prior to signing.

Please contact your broker or account representative if you have any questions or would like to provide feedback regarding the use of the forms.

 

 
 
RELATED NEWS:
ACTION REQUIRED: Multi-Factor Authentication Launching In The Coming Days For Employer Web Accounts

Univera Healthcare Welcomes Dr. Martin Stallone To Executive Leadership Team

2025 Gag Clause Attestation Process & Separate Letter Notification

2026 Individual Market Plans

2026 Annual Rate Notices Being Mailed

CATEGORY:

Univera

Employer

Employer Specific

Small Business

Midsize & Large Business

Online Account

 

GDPR Notification Content