These forms and documents explain how to complete the application process and make changes to your existing coverage:
- Employer group application (Large and Small) WI
- Employer group application(Large) IL
- Employer group application(Small) IL
- IL Enrollment application
- WI Enrollment application- FILLABLE VERSION
- Change of status – FILLABLE VERSION
- Member benefit directory
- Coordination of Benefits
- Auto Withdrawal Form FILLABLE VERSION
- Employer Handbook- Administrative Guide
- Provider Appeal Form
If you have any questions regarding the forms and documents listed here, please call MercyCare Health Plans at (800) 895-2421.