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  • Review Benefits
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ALVMA Health Trust-1Homepage
  • Review Benefits
  • Employer Agreement
  • FAQs
  • Open Enrollment
  • Qualified Life Event
  • Documents & Forms
  • Review Benefits
  • Employer Agreement
  • FAQs
  • Open Enrollment
  • Qualified Life Event
  • Documents & Forms

Participating Employer Agreement

Active employer members of ALVMA who wish to participate in the ALVMA Health Plan must sign and submit a Participating Employer Agreement prior to being eligible to enroll. If your company is already participating in the plan, there is no need to sign and submit another agreement. Click the button below to view and sign the Participating Employer Agreement.
Download Participating Employer Agreement

ACH Billing Form

Active employer members of the ALVMA who wish to participate in the ALVMA Health Plan must sign and submit an ACH Authorization Form to facilitate the secure and timely processing of monthly premium payments. This form ensures that your payments are automated, accurate, and hassle-free. If your company has already submitted an ALVMA Authorization Form, there is no need to provide another. Click the button below to view, complete, and submit the ACH Authorization Form.
Download ACH Billing Form

Once signed, please return to Patrick Pittman at patrick@southviewbenefits.com.

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