Eligibility for Small Group (summary) Benefits
1

2
3		 2-50 eligible people (w2, partners, sole proprietors, corporate officers...not 1099) can include part-time or not.
75% of eligible people must go with the plan.
Employer must pay at least 50% of employees premium.		 1
2
3
4		 Plans are guaranteed issue... regardless of health.
Premiums by employer are 100% tax deductible.
Employers can pay as little as 50% of the employees premium.
Can offer choice of plans to each employee.

Send Information to:                                                                                                            I want information on:

First Name

Last Name

company

address

city

state

Coverage is for   
Nevada companies only
zip

county

Tel

Fax

e-mail

Current Coverage
Current Carrier
Company


 Blue Cross/Blue Shield
Health Net of Nevada
No Preference -
   send least expensive according to selection below 
Medical All Plans
MSA High-ded
No-Deductible  
     Copays PPO
Deductible PPO
HMO
Basic
Dental PPO Dental
HMO Dental

Life 
Include quote 
Please describe your business
Base my request on:                        
Age

Dependents

 Gender Zip leave blank
 if same as company
Employee 1

Employee 2
Employee 3
Employee 4
Employee 5
Employee 6
Employee 7
Employee 8
Employee 9
Employee 10
Employee 11
Employee 12
Employee 13
Employee 14
Employee 15

For groups over 15 
 		  
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