Tim Wiedman Associates
--Where Serving you is our Number One Priority--
Client Services for John Alden
Forms for John Alden: For additional infomation from John Alden visit their website at http://www.assuranthealth.com.
The following forms are for new groups setting up their plans. These should be returned to Tim Wiedman Associates:
Employee Application (Indiana)
Employee Application (Michigan)
Employee Application (Ohio)
Employer Application (Indiana)
Employer Application (Michigan)
Employer Application (Ohio)
To add a new employee, or change the status (ie add/remove child, etc) for established groups, use the appropriate employee app above. After completion, fax to John Alden at (317) 844-4978. To terminate an employee from the plan, call (800) 328-4316. When adding a new employee, be sure to complete the request within the time allowed for your waiting period. If you do not remember your waiting period, please contact us or call John Alden customer service at (800) 328-4316.
Note: These forms are in Adobe Portable Document Format (PDF). In order to view PDF files, you will need the Adobe Acrobat Reader. The reader is available for downloading free of charge at http://www.adobe.com/products/acrobat/readstep.html.
The following forms are for new groups setting up their plans. These should be returned to Tim Wiedman Associates:
Employee Application (Indiana)
Employee Application (Michigan)
Employee Application (Ohio)
Employer Application (Indiana)
Employer Application (Michigan)
Employer Application (Ohio)
To add a new employee, or change the status (ie add/remove child, etc) for established groups, use the appropriate employee app above. After completion, fax to John Alden at (317) 844-4978. To terminate an employee from the plan, call (800) 328-4316. When adding a new employee, be sure to complete the request within the time allowed for your waiting period. If you do not remember your waiting period, please contact us or call John Alden customer service at (800) 328-4316.
Note: These forms are in Adobe Portable Document Format (PDF). In order to view PDF files, you will need the Adobe Acrobat Reader. The reader is available for downloading free of charge at http://www.adobe.com/products/acrobat/readstep.html.
