Small Group Indemnity Providers

Step 1 of 2: Medical profile   Gender Date of birth Height Weight Smoker? Applicant* M F / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Spouse -- M F / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children 0  1 2 3 4 5 6         Children -- M F   / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children -- M F   / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children -- M F   / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children -- M F / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children -- M F   / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Children -- M F   / / Ft 4 5 6 7 In 0 1 2 3 4 5 6 7 8 9 10 11 Currently Insured?* Yes No Have conditions?* yes   no Please specify  Take medications?* yes   no Please specify  Step 2 of 2: Tell us about yourself First Name* Last Name* Address* City* State* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip* Day Phone* Evening Phone* Contact Time* Morning Afternoon Evening Email* By submitting this form, you agree to be legally bound to, and abide by, the Privacy Policy.

AETNA

Traditional Choice®

The Traditional Choice plan provides indemnity health insurance, which gives your employees the most freedom of choice as patients. If you offer one of Aetna's network plans in a given location, you can also cover employees outside of the plan's service area by combining with Traditional Choice.

CIGNA

CIGNA HealthCare indemnity plans combine traditional fee-for-service features with some aspects of managed care in order to give your employees the freedom to choose any provider, anywhere, while still maintaining costs. CIGNA also provides a range of cost containment options and benefits so you can customize a plan that specifically meets the needs of your business.

UNITEDHEALTHCARE

UnitedHealthcare Managed Indemnity health insurance allows your employees to choose any provider or hospital they wish to use. These indemnity plans contain managed care features to cover a percentage of covered medical expenses, once the annual deductible is met.

UnitedHealthcare Managed Indemnity Highlights:

• Freedom to choose any licensed medical provider or hospital
• No referrals needed to see specialists
• Initial deductible
• Percentage of expenses covered after deductible

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