Downloadable Forms
Forms
Below are forms and information packages that will be useful as we begin, and continue, our working relationship together:
- TPA Questionnaire
- ECU Disclosure Statement & Generic Evidence Application
- New ICD9 Codes On Disclosure
- Specific Reimbursement Request Form
- Specific Stop Loss 50% Notification Form
- Aggregate Submission Form
- Claim Notice & Filing Procedures
- Specific Claim Submission Checklist
- Pre-screen Checklist (excel spreadsheet)
For more information, please contact us.
News & Events
- May 27, 2011
ECU Announces New Enhanced
EZ AGG™ - May 24, 2011
2012 ECU Producers Conference - March 1, 2011
ECU Celebrates 10th Year Anniversary - December 2010
Christmas party photos - November 10, 2010
ECU adds Gerber Life Insurance Company Paper - October 1, 2010
ECU Introduces Jeff Perkins as VP of Sales - January 1, 2010
ECU Announces Partnership with Niagara Re - May 12, 2008
Mike Hirsch Joins ECU as VP of Sales - January 1, 2007
ECU and Pan-American Announce New Small Group Aggregate Only Product - April 25, 2005
ECU adds Pan American Life Insurance Paper
Downloadable Forms
Forms and information packages available online — click here.
Spartanburg SC 29302
Phone: (864) 542-1565