Four Seasons Insurance - Group Health Insurance

These links will help you insure small or large groups with health insurance.

All forms are available in PDF Format and require the most current version of Adobe Acrobat reader to be viewed. Use this link to download it:

All forms can be printed, filled out, and faxed to 219-663-1416 or sent to:

ATTN: Jim Zienin
10971 Four Seasons Pl.
Crown Point, IN 46307

If you have any questions, feel free to contact Jim Zienin at 219-663-0900!

Group Health Insurance Forms
This will link you to Anthem's website where you can download any group health insurance form which you may need. Contact Jim Zienin at (219) 663-0900 if you need help choosing which form is best for you!

Group Administration Manual
Use this link to contact Jim Zienin to receive a copy of your group administration manual or certificates of coverage

Employee Enrollment Form
Use this form for enrolling a new group of employees or for adding on to existing groups