| Form Name | Effective Date | Download Form |
|---|---|---|
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New Group Submission |
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New Business Submission Checklist - Group Size 2-19 & Virgin Groups |
01/01/2020 | Download |
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New Business Submission Checklist - Group Size 20+ |
01/01/2020 | Download |
|
Restaurant & Hospitality Association Benefit Trust Employer Application |
01/01/2020 | Download |
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Restaurant & Hospitality Association Benefit Trust Participation Agreement |
01/01/2020 | Download |
|
Direct Debit Authorization Form |
01/01/2020 | Download |
|
Participation Certification Form |
03/01/2020 | Download |
|
Product and Benefit Selection Form |
10/01/2020 | Download |
|
New Business Binder Check Coversheet |
01/01/2020 | Download |
| Form Name | Effective Date | Download Form |
|---|---|---|
|
Enrollment and Change Forms |
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RHABT Employee Application Group Size 2-19 |
01/01/2020 | Download |
|
RHABT Employee Application Group Size 20+ |
01/01/2020 | Download |
| Form Name | Effective Date | Download Form | |
|---|---|---|---|
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Restaurant & Hospitality Association Benefit Trust plans are available to eligible National Restaurant Association member groups of 2-99 full-time employees. All groups are written on UnitedHealthcare of Illinois Large Group plans and have a choice of over 130 plans and multiple Rx options. See the product grid below for plan information and contact your RBG office for specific plan summaries. |
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2020 Restaurant & Hospitality Benefit Association Trust Benefit Grid |
09/01/2020 | SBC |
| Form Name | Effective Date | Download Form |
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| Form Name | Effective Date | Download Form |
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