Employer Forms
Employer Forms
For your convenience, you can download the following forms:
Enrollment/Application Form - use this form to add or terminate employees and/or dependents.
Notice of Late Enrollment Rights - If your employees do not wish to be covered by the Health Plan, have them complete this form informing them of their rights to enroll late.
Grandparent Affidavit - if your employee would like to cover your grandchild(ren), they may under the following condiditons:
- They must live with you and you must claim them as a dependent on your income tax return.
- You must have the Grandparent Affidavit notorized and turn it in with an enrollment application.
Automatic Payment System (APS) - complete and return this form to your SWHP account representative to have your monthly payments automatically withdrawn from your bank account.