Commercial, Personal & Medical Documents
Need an enrollment form for your group health insurance? Want to change the billing address for your policy? Better yet, do you wish to make the insurance experts at Curran Coony Penny your official agent?
This page contains useful forms in pdf or Word format that you can download and print for your convenience. All files are in PDF or DOC format.
Commercial Lines
- New York State Anti-Arson Application
- New York State Insurance Fund – Application for Workers’ Compensation
- Business Insurance Questionnaire
- Real Estate Questionnaire
- Commercial Endorsement
- Hold Harmless Agreement (Short)
- Hold Harmless Agreement (Long)
Personal Lines
- Report of Motor Vehicle Accident
- What to do in the case of an accident – Checklist
- New York State Anti-Arson Application form
- Elevation Certificate
Medical
- COBRA – Sample Letter
- COBRA – Sample Follow Up Letter
- COBRA – Termination Letter
- COBRA – Notice of Qualifying Event
- COBRA – Notice of Unavailability
- COBRA – General Notice
- HIPAA Certificate Form
Empire Blue
- Small Group Application
- Enrollment/Change Form
- Enrollment/Change Form in Spanish
- Small Group Recredentialing Form
- Group Contract for HMO or Direct HMO
- Student Questionnaire
- Renewal Worksheet
UnitedHealth/Oxford
- Small Group Application
- Contact/Address/Name Change
- Member Enrollment Form
- Addition/Termination Changes
- COBRA Election Form
LIA Health Alliance
Human Resources
Hiring Process & Reference-Checking
- Application
- CDL Addendum
- Applicant Log
- Phone Evaluation
- Interview Guidelines
- Interview Evaluation
- Background Verification
- Employment Verification
- I-9 Form
- I-9 (Spanish)
- Credit Report Authorization
- Reference Checking Guidelines
- Hold Harmless Statement
- Non-Compete Agreement
- New Hire Checklist
- Sample Rejection Letters
Records
- Check Pick-up Authorization
- Direct Deposit Authorization
- Employee Datasheet
- Employment Information Release
- Expense Reimbursement
- Mileage Reimbursement
- IT-2104
- W-4
- W-5
- W-9
Benefits
- Benefit Enrollment/Waiver Form
- NYS C2 Guide
- NYS C2 Form
- DB-450
- Health Benefit Waiver
- Illness Verification Letter
- Medical Release