Enrollment Forms
To Participate in AOI HealthChoice, employees and their dependents must meet all the eligibility requirements. Please take a moment to review the participation policies on the "Employer Information" page of this website.The following forms can be printed and used as needed. Please retain a copy for your records when making changes, and forward the original to AOI HealthChoice.
This information is provided in PDF format. For more information, please see the About This Site page.
- Employer Application
For new employers enrolling in the AOI HealthChoice program. - Employer Open Enrollment Summary
To be completed for the employer's annual renewal process only. - AOI Membership Application
- OR Group Profile Form (required for all groups)
- Employee Enrollment/Change Form
To be completed by all new or existing eligible employees for plan enrollment or when changes are necessary. - Business Verification Form (for groups of 2-10 only)
- Domestic Partner Affidavit
- Dental-Only Enrollment Forms
Employer Application
Employee Application
Open Enrollment Summary (Stand-Alone Dental groups) - AOI TotalLIFE Forms
Quote Request Form
Employer Application
Employee Application
The AOI HealthChoice Customer Service Center is available to address the needs or questions of employers, employees, agents and brokers. The Customer Service Center is open from 8am-5pm Pacific Time, Monday through Friday. The toll free number is 1-866-477-5336.
Top of page
©2001 AOI HealthChoice
Contact Us:
Plan, Benefit and Register Questions
Questions or comments regarding this site