Forms & Resources

Agent Forms & Resources

Use this information hub to submit information via DocuSign, access forms and other resources for doing business.

General Resources


Agent Compensation Schedule

Agent Compensation Disclosure Form

For Employers

Employer Death Claim

Employer Disability Claim

Enrollment Adjustment Worksheet

Request for Appointment of Personal Representative Form

Plan Members must complete this information to release PHI to a provider or other party.

Employer Portal Authorized Access

Complete and submit this information as your group’s authorized representative to have access to the Employer Portal.

Affidavit of Domestic Partnership

SafeGuard logo

General Resources

ACH Processing Form

Learn more about the plans Ascension Personalized Care (APC) offers. APC is Individual ACA Marketplace coverage.
To find your general agent, click here: