GBS Forms

• Broker Commission Direct Deposit Authorization Form
• Broker of Record Letter
• COBRA - Maryland State Extension Laws
• COBRA - One Time Mailing COBRA Subsidy Full Initial Mailing
• COBRA - Request for Treatment as AEI Form
• COBRA - Agreement to Issue Notices - Pre-Administration
• Employee Census Form
• Employee Election Approval Chart
• Employee Election Form
• Employer Group Application
• Employer Group Application COBRA Supplement
• Full Time Student Status Form
• GBS Advantage HRA ACH Authorization Form
• GBS Advantage HRA Group Agreement
• GBS Advantage HRA Reimbursement Form
• Group Enrollment Termination Report
• Group Insurance Ineligibility Listing
• Group Screening Form
• New Business Submission Checklist
• Supply Requisition Form
• Waiver card