Documentation & Forms
iiSi Document Library
For your convenience, we’ve provided a variety of downloadable documentation below for the management and administration of your iiSi stop loss insurance program.
Resource Documents
Companion Life Market Conduct Compliance Manual
This document outlines Companion Life's expectations on agent/broker marketplace conduct in the course of marketing its products.
DOWNLOAD PDFForms
Stop Loss Reimbursement ACH Request Form
Use this form to request ACH stop loss reimbursements.
Download PDFSpecific Excess Loss Claim Form
Use for specific excess loss claim reimbursement requests.
Download PDFExcess Loss Work Status Form
Use this form to provide eligibility information for plan participants.
Download PDFPotential Large Claim Alert Form
Use for claim situations requiring notification to iiSi.
Download PDFAggregate Excess Loss Claim Form
Use for aggregate excess loss claim reimbursement requests.
Download PDFISL Aggregate Excess Loss Claim Form
Use for ISL product aggregate excess loss claim reimbursement requests.
Download PDFRFP Checklist
A list of the information iiSi needs to provide an accurate and timely proposal.
DOWNLOAD PDFStandard Disclosure Form
Disclosure form for the plan sponsor to provide information on known risks.
DOWNLOAD PDFPlan Participant Disclosure Statement
Disclosure form for plan participants to provide health information.
DOWNLOAD PDF