Download the Application Form
Download the Enrollment Form
Applying for SelectFlex is easy! Simply complete the Application for your company and have each employee you are including in the benefits plan complete the Enrollment Form.
- Download the Enrollment Form
- Download the Application Form
- Download the Pre-Authorized Payment Form for Your company’s monthly billing
- Download the Direct Deposit Form for quick claims payments
Please note that a PDF reader, such as Adobe Reader is required to complete the Worksheet.