May Insurance Services, Inc.

MEDICAL MUTUAL OF OHIO
http://www.medmutual.com/

Access Request for mybrokerlink
Admin Kit (group) Policies and Procedures Z4897 3/06
App - Affadavit dle TM134
App - Group Contract Z4835 7/07
Application Employee (group 1-19) Z6115 2/10
Application Employee (group 20+) Z2729B 4/10
Application Employee (group 51+) Z1861R 3/09
Application Employer (group 1-99) Z5360 4/10
Benefits Change Form (group)
Benefit Summaries  - please go to MyBrokerLink for the lastest benefit summaries https://mybrokerlink.com/secured/
Claim Form (dental) Z3226 12/02
Claim Form (hearing) Z5145 11/06
Claim Form (major medical) SC37 4/07
Claim Form (prescription) Z3612 11/06
Claim Form (prescription reimbursement) Z1006 9/04
Claim Form (vision) Z4294 5/01
Cobra Waiver Z4801 R9/06
Deductible Credit Carryover Z2307 3/02
Dental 180 (group 1+) L7068 5/07
Dental 186 (group 10+) L7069 5/07
Dental Flyer  - see SuperMed One
Dental Traditional (group) L7070 5/07
Employer 2007 Administration Guidelines 
Group Eligibity Booklet (see Employer Administration Guidelines)
HSA First Horizon (contact the administrator directly for their application and other information)
HSA First Horizon Worksheet L6474 10/05
HSA Flyer (group/individual) Z6220 1/08
HSA Installment Flowchart
HSA Investment Options - Overview
HSA National City Bank (contact the administrator directly for their application and other information)
HSA National City Bank Worksheet L6475 10/05
Licensing - Instructions
Licensing - Producer Agreement X2346 R11/04
Licensing - Writing Agent Agreement L5747 4/06
Licensing - W-9
Life Insurance Administration Kit Z7175 3/08
Life Insurance Brochure Z7176 3/08
OHP Products & Services Brochure Z6188 8/08
OHP Benefit Packet Z6204 11/07
Prescription Drug Mail Order Z5287 3/08
Prescription Drug Program Option 1 L7062 5/07
Prescription Drug Program Option 2 L7063 5/07 
Prescription Drug Program Option 3 L7064 5/07
Prescription Drug Program Option 4 L7065 5/07
Product Grid (group) L6353 1/06
Student Certification Form Z3145 7/01
Vision Plan E L7067 5/07
Vision Value III Benefits (individual/group) L7071 5/07
Vision Value III Brochure (individual/group) Z3790 3/06
Vision Value III FAQ (individual/group) 10/03
Wells Fargo (HSA - group) Employee Brochure Z7159 11/07
Wells Fargo (HSA - group) Employee Application Z7146 11/07
Wells Fargo (HSA - group) Online Implementation Guide Z7158 11/07
Wells Fargo (HSA - individual) Brochure Z7160 11/07
Wells Fargo (HSA - individual) Application Z7147 11/07


INDIVIDUAL

Application FARM BUREAU Z7161 for use for 5/1/10 effective dates and after
Application Farm Bureau - association membership (individual) Z7188 1/08
Application SMOne - X5119 8.10
Farm Bureau Brochure Z27264 9/10
Farm Bureau Dental Plans L7350 12/07
Farm Bureau Value Plans L7352 3/08
Farm Bureau Vision Plans (EyeMed) L7351 12/07
Product Grid v6
Short Term Benefit Summary (all deductibles) L7029 4/07
Short Term Marketing Kit Z6577 11/07
SMOne Brochure X6210 09.10 (includes all plans)
SMOne Dental - Why Dental Z5515 4.06
SMOne Dental Benefits L5675 3/06
SMOne Healthy Lifestyle Questionnaire Z6351 10/05
SMOne List Bill Agreement (employee) Z6113 3/04
SMOne List Bill Agreement (employer) Z6112 3/04
SMOne List Bill Guidelines Z6107 1/05
SMOne Premium with Copay Benefit Summary 500/1000/1500/2500 2/10
SMOne Product Guidelines CS/caf5520/19023 8/05
SMOne Prescription Drug Flyer
SMOne Value Plan Benefit Summaries (all deductibles) 2/10
SMOne Vision - Why Vision Z5514 4/06
SMOne Vision Benefits L6521 4/06
SMOne Wellness Benefit Summary HSA 1500,/2500/3000/5000 2/10