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Sold
Business
Required to
Confirm
The following
items are required to confirm coverage. These items are due in our
office by the Proposal Expiration Date (usually the 1st of the
effective month).
BPI must approve
administrators (TPAs).
To begin the
approval process, refer to Third Party Administrators, Required
to Approve.
Disclosure
Statement, signed
Disclosure
Statement must be completed and signed no more than 30 days prior to
the effective date.
We accept faxed,
scanned or original documents
Approved
Third Party Administrator
Application,
signed
The application will be completed to the best of
our knowledge. Please be sure to review and
complete as needed. Contact BPI if any
information on the application is incorrect.
There are several
state specific applications. Unless otherwise noted, the
application will be prepared according to the location of the group
headquarters provided in the underwriting submission. An authorized
official of the group must sign the application in this state.
We accept faxed,
scanned or original documents.
Producer/Brokers
Licensing
Refer to
Producer/Brokers, Required for Sold Business.
Premium Deposit (first year only)
The inital premium
deposit should be equal to the first month's Specific and Aggregate
premium. A remittance form or detail of the calculation should be
included.
Make check payable
to:
United HealthCare Insurance Company
(UHIC) on behalf of BP Inc.
Mail inital Premium
Deposit to:
BP Inc.
6160 Summit Drive, Suite 345
Brooklyn Center, MN 55430
Phone: 763-569-3210 |