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  • Integrated Healthcare Consumer Driven Healthcare - An Integrated Solution Integrated Healthcare, LLC, the sister company of GreenWood International Insurance Services, Inc, delivers a revolutionary point-and-click Consumer Driven Healthcare Platform that merges both health and wealth information, giving employees easy access with just one log-in. This platform strives to change employee behavior through financial incentives and informational tools including Health Savings Accounts, smoke-cessation programs, weight management programs, and health risk assessments.

    Promoting the long-term health of employees in an effort to improve their quality of life and reduce their employers’ healthcare costs is the goal of Integrated Healthcare, LLC. With this cost-effective, forward-thinking approach, Integrated Healthcare, LLC provides employers and employees an array of proven-effective products and services along with innovative online tools that allow them to effectively manage their health and associated costs.

    To learn more about enhancing bottom-line healthcare costs in today’s competitive marketplace, click here
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Forms

Get ADOBE READERAll forms are in Adobe PDF Format. If needed, please download Adobe Reader via the link to the left to view.

Administration Forms

Please contact Laurie Cardin, Manager of Administration at GreenWood International Insurance Services, Inc (lcardin@gwigroup.com, 617.502.3028) for more information.

ACE Premium Reporting Form should be mailed along with payment and back-up to:
GreenWood International Insurance Services, Inc.
Department 200
P.O. Box 4110
Woburn, MA 01888-4110
Premium Reporting Form should be mailed along with payment and back-up to:
GreenWood International Insurance Services, Inc.
Department 540
P.O. Box 4110
Woburn, MA 01888-4110

TPA - SIIA Appointment Questionnaire

Licensing and Appointment forms should be sent to:
Attn: Laurie Cardin
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

 

Group Accident Forms

Please contact Laurie Cardin, Manager of Administration at GreenWood International Insurance Services, Inc (lcardin@gwigroup.com, 617.502.3028) for more information.

Travel Exposure Questionnaire

Group Accident Forms should be sent to:
Attn: Laurie Cardin
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

 

Medical Stop Loss Forms

Please contact Laurie Cardin, Manager of Administration at GreenWood International Insurance Services, Inc (lcardin@gwigroup.com, 617.502.3028) for more information.

Agent Appointment Forms should be sent to:
Attn: Laurie Cardin
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

GWI Medical Stop Loss Application

Medical Stop Loss applications should be sent to:
Attn: Jaime Valcanas
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

Renewal Checklist

Renewal information should be sent to:
Attn: Bonnie Walsh
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

W-9

 

Occupational Accident Forms

Please contact Laurie Cardin, Manager of Administration at GreenWood International Insurance Services, Inc (lcardin@gwigroup.com, 617.502.3028) for more information.

PEI Quote Sheet

AH-10001: Occupational Accident Policy, Pay on Behalf

AH-10004-R: Occupational Accident Policy, Reimbursement

AH-10005: Pay on Behalf Group Master Application

AH-10005-R: Reimbursement Group Master Application

TX Nonsub Compliance Pkg Forms 5 & 7

Occupational Accident forms should be sent to:
Attn: Lynda Edmondson
2800 South IH-35, Suite 275
Austin, TX 78704

 

Claim Forms

Please contact Laurie Cardin, Manager of Administration at GreenWood International Insurance Services, Inc (lcardin@gwigroup.com, 617.502.3028) for more information.

Medical Stop Loss Claims

Stop Loss Claim Forms should be sent to:
Attn: Denise Ard
GreenWood International Insurance Services, Inc
225 Franklin Street, Suite 1201
Boston, MA 02110
F: 617.728.8268

Occupational Accident Claims

Texas Healthcare Foundation Claims Reporting Procedures

Texas Healthcare Foundation DWC Forms 5 and 7

Texas Healthcare Foundation Taxation of Disability Benefits

THF Forms for claims should be sent to:
Texas Healthcare Foundation
1278 FM 407, Suite 105,
Lewisville, Texas 75077
F: 972-317-0889.

ACE USA Claims

Midlands Claim Admn

ACE Claim Forms should be sent to:
Midlands Claim Administrators, Inc.
P.O. Box 238808
Oklahoma City, OK 73123
F: 888-799-5628