Employer Forms

Click to download a pdf of the Form you would like to view.

COBRA Notice of Right to Continue
This form is used for employees who are electing to continue coverage.
Employee Enrollment Form
Employee enrollment form which includes consent form.
Employee Change Form
This form is for any changes made to employee information such as name, address, or primary physician.
Termination Form
This form is for terminating an employee or a dependent.
Wisconsin Notice of Right to Continue Group Health
This form is used for employees who are electing to continue coverage.
Wisconsin Continuation Request for Info
Request for Information - Involuntarily Terminated Insureds NOT currently covered under Wisconsin Continuation.

Request an ID Card on Behalf of a Member

To request a new or additional identification card on behalf of a member, please call Jennifer Walske, in the Arise Health Plan Billing and Enrollment Department, at (920) 490-6978.