Humana/Employers Health Insurance Company

• Company Website

• Dental Forms

  Vision Benefit with Humana Dental

• Medical Forms

  • Enrollment Forms for Georgia

    • 2-9 Employees (English) (Spanish)

    • 10-25 Employees (English) (Spanish)

    • 26+ Employees (English) (Spanish)

    • Change Form (English) (Spanish)

    • Additional Information Form (English) (Spanish) 

  • State Continuation Form

• Open Access Point of Service Plans

  • OPEN ACCESS PLUS PLAN 80/60 500-20

  • OPEN ACCESS PLUS PLAN 80/50 1,000-30

  • OPEN ACCESS PLUS PLAN 90/70 500-15

  • OPEN ACCESS PLUS PLAN 90/70 1,000-20

  • OPEN ACCESS PLUS PLAN 100/70 2,000-20

  • OPEN ACCESS PLUS PLAN 100/50 1,000-20

• Rx4 Pharmacy Program

  • $10/20/40/25%

  • $10/25/45/25%

  • $10/25/50/25%