Below are the Carrier Forms needed to submit your group to First National Administrators. 

• Aetna NY
• Aetna NYC Community Plan
  
• Aetna NJ
• Aetna CT
• Aetna HSA
  
• AmeriHealth NJ
  
• Atlantis NY
• Chartis LimitedMedical
• Cigna NY
• Cigna NJ
• Emblem Health NY
• Emblem Health HSA
  
• Empire BCBS NY
• Health Net NY
• Health Net NJ
• HealthPass NY
  
• HIP NY
• HIP Smart Start
  
• Horizon BCBS NJ
  
• LIA Health Alliance NY
• Oxford NY Freedom/Liberty OHP
  
• Oxford NY
• Oxford HSA
• Oxford NJ OHI
  
• Oxford NJ
• Oxford NY HMO
• Oxford NJ HMO
  
• Oxford Sole Proprietor
• United Healthcare - Large Group

 Aetna NY

• FNA Aetna NY Submission Guidelines*
• Aetna NY New Business Case Submission Checklist
• Aetna NY Small Group Employer Application
• Aeta NY Small Group Employee Enrollment/Change Form
• Proof of Eligibiliy Form
• Associated Companies Form
• Aetna Late Paperwork Submission Form
• Dependent Questionairre
• Aetna NY-NNJ Employer Funding Certification and Statement of Understanding for Small Employers
  
• Complete Kit

Aetna NYC Community Plan

• Aetny NYC Community Plan Employer Application
• Aetna NYC NY Small Enrollment Change Form
• Aetna NY-NNJ Employer Funding Certification and Statement of Understanding for Small Employers
  
• Complete Kit

Aetna NJ

• FNA Aetna NJ Sumbission Guidelines
• Aetna NJ Small Group New Business Case SubmissionChecklist
• Aetna NJ Application for Small Group Benefits
• Aetna NJ Employer Certification
• Aetna NJ Small Group Employer Application
• Aetna NJ Small Group Business Enrollment/Change Request
• Aetna NJ Small Group Business Waiver of Coverage
• Aetna NJ Proof of Eligibility
• Aetna NJ Small Group Life/Disability/DentalEnrollment Change form
• Aetna NY-NNJ Employer Funding Certification and Statement of Understanding for Small Employers
  
• Aetna NJ Complete Kit

Aetna CT

• FNA Aetna CT Submission Guidelines
• Aetna CT Small Group Employer Application
• Aetna CT Small Group Employee Enrollment Application
• Aetna CT Employer Verification Form
• Aetna CT Family Health Statement
• Complete Kit

• Aetna Health Equity HSA Welcome/How to Enroll
• Aetna Health Equity HSA Employer Enrollment Form
• Aetna Health Equity HSA Employee Enrollment Form
• Aetna Health Equity HSA Beneficiary Designation Form
• Aetna Health Equity HSA Custodial Agreement
• Aetna Health Equity HSA Rollover Request Form
  
• Aetna Health Equity HSA Implementation Guide
• Aetna Health Equity HSA Brochure
• Aetna Health Equity HSA Fee Schedule
  
• Aetna NY-NNJ Employer Funding Certification and Statement of Understanding for Small Employers
  
• Complete Kit

 AmeriHealth

• FNA Amerihealth Submission Guidelines
• AmeriHealthAccount Installation Checklist
• AmeriHealth Application for Small Employer Health Benefits Policy
• AmeriHealth Employer Group Enrollment Application
• AmeriHealth Small Employer Certification Form
• AmeriHealth Employee Enrollment/Change Application
• AmeriHealthDependent to Age 30 Enrollment Application
• AmeriHealth Small Employer Waiver of Coverage 
• AmeriHealth Employer Authorization Letter for EFT of Initial Premium
  
• AmeriHealthPlan Change Letter
• Complete Kit

Atlantis HealthPlan

• FNA Atlantis Submission Guidelines*
• Atlantis Group Eligibility List
• Atlantis Enrollment and Waiting Periods
• Atlantis Required Documentation
• Atlantis Group Agreement Form
• Atlantis Employee Enrollment Form
• Atlants Health History Coverage Form
• Atlantis Notice of Enrollment and Waiver
• Atlantis Credit Card/Debit Card Premium Authorization
• Complete Kit

Chartis Limited Medical

• FNA Chartis Submission Requirements
• Chartis Sold Case Form
• Chartis Individual Enrollment Form
• Chartis Premium Calculation Sheet
• Chartis Add/Term Form
• Complete Kit
  

Cigna NY

• FNA Cigna NY Submission Guidelines
• Cigna NY Underwriting Guidelines
• Cigna NJ Small Group Employer Group Application
• Cigna NY Small Employer Certification Form
• Cigna NY Enrollment/Change form
• Ciga NY Small Employer Health Benefits Waiver
• Cigna NY CAF-1 Form
• Cigna NY CAF-4 Form
• Cigna NY Late Paperwork Form
• Complete Kit

Cigna NJ

• FNA Cigna NY Submission Guidelines
• Cigna NJ Underwriting Guidelines
• Cigna NJ Small Group Employer Group Application
• Cigna NJ Enrollment Change form
• Cigna NJ Small Employer Certification Form
• Cigna NJ Small Employer Health Benefits Waiver
• Cigna NJ CAF- 1 Form
• Cigna NJ CAF-4 Form
• Cigna NJ Late Paperwork Form
• Cigna NJ Offer Form for Domestic Partnership
• Cigna NJ Affadavit of Domestic Partnership
• Complete Kit

• FNA Cigna CT Submission Guidelines
• Cigna CT
• Complete Kit

Emblem Health

• FNA Emblem Health Submission Guidellines*
• Emblem Health Letter of Certification
• Emblem Health Small Employer Group Application
• Emblem Health Transaction Form for Group Accounts
• Emblem Health Small Group Waiver
  
• Emblem Health Student Verification Form
• Emblem Health Claim Form
• Emblem Health Domestic Partner Enrollment Policy
• Complete Kit

Emblem HSA

• FNA Sumission Requirements for Emblem HSA
• Emblem Health HSA Small Employer Group Application
• Emblem Health HSA Letter of Certification
• Emblem Health HSA Transaction Form for Group Health
• Emblem Health Student Verification Form
• Emblem Health HSA Application
  
• Emblem Health HSA Employer Set-up form
• Emblem Health HSA Contribution Work Sheet
• Complete Kit

Empire BCBS

• FNA Large Group Underwriting Requirements
• FNA Large Group Request for Quote

Health Net NY

• FNA HealthNet NY Submission Guidelines
• Health Net NY Case Submission Checklist
• Health Net NY Employer Application
• Health Net NY Outlook EPO Advantage Enrollment Form
• Health Net NY Outlook POS Advantage Enrollment Form
• Health Net NY Outlook PPO Advantage Enrollment Form
• Health Net NY New Enrollee Pre-existing Condition Form
  
• Health Net Change Cancellation Form
• Health Net NY Waiver of Coverage Form
• Health Net NY Student Verification Form
• Health Net NY Late Submission Form
• HealthNet HSA Kit
  
• Complete Kit

Health Net NJ

• FNA Health Net NJ Submission Guidelines
• Health Net NJ Case Submission Checklist
• Health Net NJ Small Employer Certification Form
• Health Net NJ Application for Small Group Health Benefits
• Health Net NJ Enrollment/Change Request Form
• Health Net NJ Request for Waiver of Coverage
• Health Net NJ Pre-Existing Condition Outlines
• Health Net NJ Late Submission Form
• HealthNet HSA Kit
• Complete Kit

HealthNet CT

• FNA Health Net CT Submission Guidelines
• Health Net CT Underwriting Guidelines
• Health Net CT New Group Case Submission Checklist
• Health Net CT Group Coverage Enrollment Application
• Health Net CT HMO Advantage Enrollment Application
• Health Net CT POS Advantage Platinum Enrollment Application 
• Health Net PPO Enrollment Form
  
• Health Net Charter HMO Platinum Enrollment Form
  
• Health Net CT PPO Pre-Existing Condition Questionnaire
• Health Net CT New Enrollee Pre-Existing Conditions Information Form
• Health Net CT Waiver of Coverage
• Health Net CT/NY Prescription Transfer Form 
• Health Net CT Student Verification Form
  
• Health Net CT Late Submission Form
• Complete Kit

HealthPass

• FNA HealthPass Submission Guidelines*
• HealthPass Eligilibility Guidelines 
• HealthPass Enrollment Checklist
• HealthPass HSA Checklist
• HealthPass Notice of Election
• HealthPass Enrollment/Change Form
• HealthPass Partners, Officers or Owners Verification Form
• HealthPass Group Underwriting, Enrollment & Admin Requirements
• HealthPass Electronic Funds Transfer Form 
• HealthPass Network Availability
• HealthPass Pharmacy Options
• HealthPass Affadavit of Domestic Partnership
• HealthPass Declaration of Cohabitation
• HealthPass Domestic Partner Registration Info Sheet
• Complete Kit

HealthAdvocate

• FNA HealthPass Submission Guidelines
• Complete Kit
  

HIP

• FNA HIP Submission Guidelines*
• HIP Underwriting Guidlines 7/1/10
  
• FNA HIP Smart Start Submission Guidelines*
• HIP New Business Underwriting Checklist
• HIP Subscriber Member Enrollment Form
• HIP Group Application
• HIP Refusal of Insurance
• HIP Prime Small Group Application
• HIP Change/Term Transmittal Sheet
• HIP Select EPO Small Group Option Sheet
• HIP Prime EPO Smal Group Option Sheet
• HIP Prime PPO Small Group Option Sheet
• HIP Prime POS Small Group Option Sheet
• HIP Access I Small Group Option Sheet
• HIP Access II Small Group Option Sheet
• HIP Classic Small Group Option Sheet
• HIP Domestic Partner Coverage Details
• Complete Kit

HIP Smart Start

• FNA HIP Smart Start Submission Guidelines
• HIP Smart Start Group Application
  
• HIP Smart Start Late Paperwork Application
• HIP Smart Start Plan Options
• HIP Smart Start Refusal of Insurance
• HIP Smart Start Member Enrollment Form
• HIP Smart Start Student Resert
• HIP Smart Start Transmittal
• HIP Smart Start Underwriting Guidelines
  
• HIP Smart Start Complete Kit
  

Horizon BCBS NJ

• FNA Horizon BCBS NJ Submission Guidelines
• Horizon Application for Small Group Health Benefits
• Horizon Small Employer Certification
• Horizon Group Enrollment/Change Request
• Horizon Small Employer Verificaton Form (2 - 5)
• Horizon Small Employer Waiver Form
• Horizon Employment Verification for Husband & Wife Groups
• Horizon Conversion Request Form or Renewals
• Horizon HSA Declaration of Understanding
• Horizon HSA ACS/Mellon Health Savings Account Employer Discovery Document / Set-up Form
• Horizon HSA ACS/Mellon Small Employer Group Setup Information
  Horizon Late Paperwork Form
• Horizon Dependent To Age 30 Enrollment Form Template
• Horizon Student Verification Questionaire
• Complete Kit

• Horizon Conversion Form
  

LIA Health Alliance

• FNA LIA Submission Guidelines*
• LIA New Business Checklist
• LIA Employer Application
• LIA Employer Agreement
• LIA Broker Registration
• LIA Electronic Debit Form
• Complete Kit

• FNA Oxford Freedom/Liberty OHP Submission Guidelines
• NYCommunity Rated Small Group App - OHP 
• NY Member Enrollment Form - OHP  
• Oxford NY Health Benefits Waiver of Coverage Form
• Oxford NY Dental Enrollment Form
• Oxford NY Add/Term/Change Form
• Oxford NY Student Verification Parent Affidavit Form
• Oxford NY USA Addendum
• Oxford Concent for Broker to Act as BA
• Oxford Freedom/Liberty OHP Complete Kit
  

Miscellaneous Forms

• Oxford New Plan Election Form
  

Oxford NY OHP Liberty HMO

• FNA Oxford Liberty HMO Submission Guidelines*
• Oxford NY HMO Small Group App - OHP
• Oxford OHP Member Enrollment Form
  
• Oxford NY Health Benefits Waiver of Coverage Form
• Oxford NY Dental Enrollment Form
• Oxford NY Add/Term/Change Form
• Oxford NY Student Verification Parent Affidavit Form
• Oxford NY USA Addendum
• Oxford Concent for Broker to Act as BA
• Oxford NY OHP Liberty HMO Complete Kit
  

Oxford NY

• FNA Oxford NY Sumbission Guidelines
• Oxford NY Small Group Application
• Oxford NY Member Enrollment Form OHI
  
• Oxford NY Health Benefits Waiver of Coverage Form
• Oxford NY Student Verification Parent Affidavit Form
• Oxford NY Add/Term/Change Form
• Oxford NY Dental Enrollment Form
• Oxford NY Group Dental/Vision Form
• Oxford NY USA Addendum
• Complete Kit

• Oxford HSA Cerfiticate of Understanding
• Oxford NY HSA Application
• Oxford NY OptumHealth HSA Contribution Form
• Oxford NY OptumHealth HSA Set-Up Bank Notification
• Complete Kit

Oxford NJ OHI

•  FNA Oxford NJ OHI Submission Guidelines
• Oxford NJ Small Group Application - OHI
• Oxford NJ Small Employer Member Enroll/Change Request Form OHI
• Oxford NJ Waiver of Coverage
• Oxford NJ Small Employer Certification
• Oxford NJ Add/Term/Change Form
• Oxford NJ HSA Certificate of Understanding
• Oxford NJ Optum Health Bank HSA Application
• Oxford NJ HSA Employer Contribution Form
• Oxford NJ OptumHealth HSA Set-UP Bank Notification
• Oxford NJ Student Verification Parent Affidavit Form
• Oxford NJ Dental Enrollment Form
• Oxford NJ Temporary HINT Supplemental Enrollment Form
• Oxford Consent for Broker to Act as BA
• Complete Kit
  

Oxford NJ

• FNA Oxford NJ Submission Guidellines
• Oxford NJ Small Employer Certification
• Oxford NJ Small Employer Member Enrollment Change Request Form
• Oxford NJ Waiver of Coverage
• Oxford NJ Add/Term/Change Form
• Oxford NJ Student Verification Paretn Affidavit Form
• Oxford NJ Dental Enrollment Form
• Oxford NJ Temporary HINT Supplemental Enrollment Form
• Oxford NJ USA Addendum
• Oxford Consent for Broker to Act as BA
• Complete Kit

Oxford NJ OHP HMO

• FNA Oxford NJ OHP HMO Submission Guidelines
• Oxford NJ OHP HMO Small Employer Application
  
• Oxford NJ OHP HMO Member Enrollment/Change Form
• Oxford NJ OHP HMO Waiver of Coverage
• Oxford NJ Small Employer Certification
• Oxford NJ Student Verification Parent Affidavit Form
• Oxford NJ Add/Term/Change Form
• Oxford NJ Dental Enrollment Form
• Oxford NJ Temporary HINT Supplemental Enrollment
  
• Oxford NJ USA Addendum
• Oxford Consent for Broker to Act as BA
• Oxford NJ OHP HMO Complete Kit
  

 Oxford NJ OHI - Freedom/Liberty/Direct/My Plan/HSA

• FNA Oxford NJ Submission Requirements Freedom/Liberty/Direct/My Plan/HSA
  
• Oxford NJ Small Employer Application OHI
  
• Oxford NJ Small Employer Member Enrollment/Change Form- OHI
  
• Oxford NJ Waiver of Coverage
• Oxford NJ Small Employer Certification
• Oxford NJ Add/Term/Change Form
• Oxford NJ Student Verification Parent Affidavit Form
• Oxford NJ Dental Enrollment Form
• Oxford NJ Temporary HINT Supplemental Enrollment
• Oxford NJ HSA Certificate of Understanding
•  Oxford NJ Optum Health Bank HSA Application
• Oxford NJ HSA Employer Contribution Form
• Oxford NJ OptumHealth HSA Set-UP Bank Notification
• Oxford NJ Student Verification Parent Affidavit Form
• Oxford NJ Dental Enrollment Form
• Oxford NJ Temporary HINT Supplemental Enrollment Form
• Oxford Consent for Broker to Act as BA
• Oxford NJ OHI Freedom/Liberty/Direct/MyPlan/HSA Complete Kit

• NJ Individual Application-Change OHI
• NJ Individual Application-Change OHP
• NJ Small OHP Enrollment Form
• NJ Large Enrollment OHP
• NJ Large Enrollment OHI

Oxford NJ HSA

• Oxford NJ HSA Certificate of Understanding
• Oxford NJ Optum Health Bank HSA Application
• Oxford NJ HSA Employer Contribution Form
• Oxford NJ OptumHealth HSA Set-UP Bank Notification
• Complete Kit

Oxford Sole Proprietor

• FNA Oxford Sole Proprietor Submission Requirements
• Oxford Sole Proprietor Required Documentation
• Oxford Sole Proprietor Application
• Oxford Sole Proprietor Group Attestation Form
• Oxford Sole Proprietor NY Member Enrollmen & Physician Selection Form
• Optum Health Bank HSA Application
• Optum Health Bank Setup Notification
• Optum Health Summary of Coverage
• Complete Kit
  

United Healthcare

• FNA Large Group Underwriting Requirements
• FNA Large Group Request for Quote

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