Enrollment Kit - sutter health plus (medical)
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Effective Date
Current As Of
"Current As Of" signifies the latest date on which a Word & Brown
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revised version accessible.
This checklist is provided as a guide. The carrier may require additional items and documentation. Please refer to the carrier's underwriting guidelines for a complete list of requirements. Please use the latest version of forms.
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 Sutter Health Plus's case submission requirements.
Small Group (1-100) Submission
- Reconciled DE-9C (required for one to nine eligible employees): VW-Valid Waiver, T-Term, PT-Part Time, E-Enrolling
Note: While not required, Sutter Health Plus Underwriting reserves the right to request a DE-9C for employers with more than ten FTEs. - Binder check for first month’s premium including dependent premium.
- Completed and signed Employer Application; including employee participation totals.
- Completed and signed Employee Application(s).
- Copy of medical quote submitted to employer.
- Sutter Health Plus Eligibility Statement (for owners not on the DE-9C)
- Completed New Employee Verification Form for employees not listed on the DE9-C or current premium invoice Note: Sole proprietors and partners do not need to complete this form; all eligible employees must be on a reconciled DE-9C or two week payroll cycle
- Please provide the following:
- Sole Proprietorship - Current California Business License, Fictitious Business Name Filing, or Current Schedule C and (1040) form
- Partnership/LP/LLC - Partnership Agreement and Federal (EIN) Assignment Letter, Current Schedule K-1 (1065), Statement of Partnership Authority, or Statement of Information (LLCs only)
- Corporation/C Corp - Articles of Incorporation, Statement of Information, Schedule K-1 1120S (for S Corp), or Tax Form 1120 (pages 1 and 2) with Schedule 1125e (for C Corp)
Submission Timeline
If you submit group cases after the 20th of the prior month, this may cause a delay in the delivery of member identification cards and welcome materials by the effective date.
Final deadline for group submissions is the first Friday of the effective month; group submissions must include completed documents and binder check.
| After approval, prior carrier termination letter must be submitted by the employer or broker. |
For other useful or older documents, please refer to the Forms database.
Important Reminder: To help your client comply with ACA requirements, provide a copy of the appropriate Summary of Benefits and Coverage (SBC) to each employee at the Enrollment Meeting, via email or by posting on an internal company website. For the most recent information regarding Aetna’s SBCs, please go to the SBC Page or contact your Word & Brown Representative.