Fillable Form Library

BASIC Guru Forms Library

The forms shown below are for use with BASIC Guru. The forms will only pre-populate when used by an employee who is signed into BASIC Guru.

Please right click on the link and choose copy hyperlink and then paste the link into your Agency Master Resource Library for assignment to your group(s) then assign the form(s) to the employees of your groups.

Don’t see forms for your state? Please contact Bret Spinks to learn more.

Federal

I-9 Form

W-4 Form

Arizona

Aetna Enrollment

BCBS Enrollment

Health Net Enrollment 

California

Aetna 2 – 50 Enrollment

Assurant DHMO Enrollment

Assurant DPPO Enrollment

Anthem 2 – 50 Enrollment

Anthem 2 – 50 Employee Change

Blue Shield 2 – 50 Employee Change

Blue Shield  2 – 50 Enrollment

Cal Choice Employee Change

Cal Choice Enrollment

Humana Employee Change

Humana Dental Enrollment 

Met Life Dental Enrollment

Safeguard HMO Enrollment

Safeguard Vision Enrollment

Florida

Aetna 2-50 Employee App 

AvMed Employee App

BCBS FL Employee App

Guardian LTD Enrollment 

Health First Health Plans FL Enrollment

Reliance Florida Dental Enrollment 

Standard FL Enrollment Dental/Life/LTD/STD

Georgia

Aetna GA EE App 

Humana GA 2-19 Enrollment

Indiana

Delta Dental Enrollment Form

Anthem Indiana 2-50 Employee Application

Anthem 51 Employee Application

Anthem ASO Employee Application

Aetna 2-50 Employee Application

UHC 100 Employee Application

UHC 2-50 Employee Application

Maine

Anthem Dental & Vision Employee Application

Anthem Employee Application

Michigan

BCN Benefit Change Part C

Delta Dental Enrollment Form

BCBS MI Enrollment – Change in Status

Priority Health Enrollment Form

HAP AHL PPO EPO Enrollment 

HAP HMO Enrollment

UHC 4 – 99 Lives Enrollment 

Humana Employee Change 

Humana Employee Enrollment

Humana Group Plan Change Request

Madison National Request for Change

Madison National Beneficiary Form

Madison National Employee Enrollment

McLaren Enrollment

McLaren Medical Waiver Form

Reliance Standard Life & Dep Life App

New Jersey

UHC Oxford Enrollment

Aetna NJ Dental

Aetna NJ EE Enrollment

Amerihealth NJ Enrollment

BCBS NJ Horizon Enrollment

Choice Care Card HRA Enrollment

UHC Oxford Enrollment 51+

UHC Dental Vision Enrollment

Unum Enrollment

Ohio

Delta Dental Enrollment Form

Anthem OH Employee App

Anthem OH Employee Change

Assurant OH Employee Enrollment

Lincoln OH Generic Enrollment

MMO 1-19 EE Enrollment

MMO 20+ EE Enrollment

Standard OH Enrollment

UHC 2-9 EE Enrollment

UHC 10-50 EE Enrollment

South Carolina

SC BCBS Enrollment

Virginia

Delta Dental Enrollment – Large Group

Delta Dental Enrollment - Small Group

Anthem Dental Enrollment

Anthem Dental Prime & Complete Enrollment

Anthem Dental Prime & Complete Maintenance Form

Anthem Life Beneficiary Form

Anthem Member Change Form

Anthem Waiver of Group Health Benefits

MetLife Change Request Form

MetLife Designation of Beneficiary

MetLife Enrollment Form (All Products)

MetLife Enrollment Form (Dental & Life)

MetLife Enrollment Form (Dental)

MetLife Enrollment Form (Life & Disability)

MetLife Statement of Health Form

Optima Enrollment – Small Group

Optima HMO Design Vantage Enrollment – Large Group

Optima HMO Vantage Member – Large Group

Optima HSA Equity Plus Enrollment – Large Group

Optima PPO Design Plus Enrollment – Large Group

Optima PPO Plus Enrollment – Large Group

Optima Student Verification Form

Universal Virginia Small Group Employee Application