Professional Group Plans
  • Broker Login
  • Request Login
  • Get In Touch

Quick Links

  • Run A Quote – BenefitFront
  • Secure Email
  • Marketing Resource Center

PGP Broker Portal

Existing Users Log In
   
Forgot Password
  • Services
  • Resources
  • Tools
  • Markets
  • About
  • COVID-19

Emblem

You will need the forms that start with a plus sign (+) to process new business.

  • + 2020 Emblem HMO Small Group Application
  • + 2021 Emblem HMO Small Group Application
  • + Emblem Healthy NY Application
  • + Emblem NY Small Group Enrollment-Change Form
  • + Emblem NY Small Group New Business Late Submission Form
  • + Emblem NY Small Group New Business Submission Guidelines
  • + Emblem NY Small Group Waiver
  • Emblem Appointment Instructions
  • Emblem HIPAA Authorization Form
  • Emblem NY RX Mail Order Form
  • Emblem NY Selling Agent Appointment Application
  • Emblem NY Selling Agent Signature Page (Recontract)
  • Emblem NY Small Group COB Form
  • Emblem NY Small Group Disability Status Request Form
  • Emblem NY Small Group Gym Reimbursement Form
  • Emblem NY Small Group Medical Claim Form
  • Emblem NY Small Group RX Claim Form
  • HealthEquity HSA Employer Enrollment
  • HealthEquity HSA Individual Enrollment Fee Form
  • Unified HIPAA BA for SA GA MGA (Appendix)
  • Unified SA Agreement with Emblem Logo

Request a Complimentary Consultation

We’d love to hear from you. Our team welcomes the opportunity to work with all brokers looking to enhance, streamline, and grow their benefits business. Simply fill out the form below and an Employee Benefits Consultant will get back to you.

Empowering Brokers.

Contact

  • Office Locations
  • Get In Touch
  • Request Login

Company

  • About
  • Careers
  • Privacy Policy

Follow Us

  • Facebook
  • Twitter
  • LinkedIn

Call an Employee Benefits Consultant

1.833.556.0101

PGP Benefits

© 2019 - 2021 Professional Group Plans. All rights reserved. | Sitemap | Privacy Policy | Long Island Web Design by Active Web Group

  • Services
  • Resources
  • Tools
  • Markets
  • About
  • COVID-19
  • Broker Login
  • Request Login
  • Get In Touch