Enrollment Kit - Camden/Avesis (Vision)
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Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval. The following list outlines Camden / Avesis case submission requirements.
- Group Application
- PPO Group Application (3 page Avesis application)
- Member Enrollment Forms
- PPO Enrollment Forms (Avesis)
- Binder Check (Including admin fee)
- PPO Check payable to Avesis
- Agent Service Agreement (If you are not already appointed)
- There is a $10.00 monthly administration fee per group.
PPO Group Application Instructions:
- PPO Group Application
- Section I – Group Information (Please include Tax ID Number)
- Section II – Plan Information (AVESIS Advantage Vision Plus Plan)
- Section III – Premium Information (Voluntary or Employer Sponsored)
- Section IV – Eligibility – please select (usually type 1 – all full time employees)
- Section V – Effective Date
- Section VI – Employer Signature (mandatory)
- Section VII – Broker Information
- PPO Employee Enrollment Form
Licensing: Broker appointment must be completed online via this link. NOTE: The group will not be approved until licensing is received.