CENTRAL OHIO GROUP
INSURANCE AGENCY, INC

Ohio's #1 Medical and Employee Benefit's Wholesaler

Agents have looked to Central Ohio Group along with BrokerNet for outstanding service, top agent contracts, sales support, education, and expertise in the health insurance marketplace since 1980.

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Anthem  - Applications, Plan Designs, and other Forms


































































Anthem
Individual OFF Exchange Forms

Document Library

NameDescription
Document2015 ApplicationOff Exchange
Document2015 Catastrophic SOB & APPOff Exchange
Document2015 Coverage DetailsDetails for Ohio
Document2015 Summary & App Off Exchange
Document2015 Plans at a GlanceOff & On Exchange
Document2015 Select Tier DrugFormulary
Document2015 Dental RatesRates
Document2015 Dental AppApplication
Document2016 On & Off Exchange Plan GuideOn & Off Exchange Plan Guide
Document2016 Off X ApplicationOff X Application
DocumentGeoBlue Travel InsuranceProduct Guide
DocumentGeoBlue Travel InsuranceEligibility Guide
Document2017 Off Exchange BrochureOff Exchange
Document2017 Select Drug ListSelect Drug List
DocumentOH Pathway HMO Network ListOH Pathway HMO Network List
DocumentPathway PPO ListPathway PPO List
Document2017 Off Exchange ApplicationOff Exchange Application
Anthem
Individual ON Exchange Forms

Document Library

NameDescription
Document2014 Benefit SummariesON Exchange (includes OFF Exchange)
Document2014 Premium PaymentAutomatic Payment Form For ON Exchange
Document2015 Catastrophic SOB & APPOn Exchange
Document2015 Plans at a GlanceOn & Off Exchange
Document2015 On Exchange SummaryOn Exchange
Document2017 On Exchange BrochureOn Exchange
Anthem
Group OFF Exchange Forms

Document Library

NameDescription
Document2015 Small Group Check ListOff Exchange
Document2015 Summary of BenefitsOff Exchange
DocumentLegacy EE Change FormLegacy Change Form
DocumentEE Termination FormEmployee Termination Form
Document2016 ACA EE Application2016 ACA EE Application
Document2016 ACA EE Change form2016 ACA EE Change form
Document2016 ACA ER Application2016 ACA ER Application
Document2016 ACA Small Group Check List2016 ACA Small Group Check List
DocumentLegacy EE AppLegacy Employee App
Document2017 ACA Change Form2017 ACA Change Form
Document2017 ACA EE Application2017 ACA EE Application
Document2017 ACA ER Application2017 ACA ER Application
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