American Westbrook Insurance Services

American Westbrook Insurance Services


Waiver of Employer Sponsored Health Insurance Coverage

For your protection as an employer, we are providing the following Waiver of Health Insurance Coverage Form for you to include with your enrollment materials to employees. Any employee declining coverage of your employer sponsored health plan, should sign this waiver annually.

You may forward copies of signed waivers to your American Westbrook client advocate to keep on file, but we also recommend that you keep a copy internally. As always, please do not hesitate to contact us with any questions you may have.

Please click here to view and print the waiver.