Employer's Forms

Below is a list of forms for employer groups that are available to the public. Additional forms may be available to you after you sign into the Employer Portal.

Large Group Enrollment and Change Form
Small Group Enrollment and Change Form
COBRA Election Form
Common Law Marriage
Coordination of Benefits (COB) Form
Employer Billing Key Code
Protected Health Information (PHI) Authorization Form
Request for Dependent Coverage Due to Incapacitation
Employer Portal User Guide

Administrative Guides

Administrative Guide (HMO)
Administrative Guide (PPO)
Administrative Guide (Dual)

CommunityCare is proudly owned by two of the region’s premier health systems. Other physicians and providers are available in our network.

Employers

SBC Tool

Employee Assistance Program (EAP)

WorkNet

Preferred CommunityChoice

Employer's Forms

Administrative Guides