<p>Please use this checklist to ensure that all forms and information needed to process your group applications are included in the submission packet.</p><p>Please Provide The Following □ GA New Group Submission Application.</p><p>□ Application for Group Insurance/Master Application.</p><p>□ Enrollment forms and/or census (formatted).</p><p>□ DHMO Application (if applicable). Please note: if DHMO sells with a PPO or another line of coverage,</p><p>MetLife will require both the DHMO Application and the Master Application.</p><p>□ Sold proposal (with broker’s signature on the rate summary page).</p><p>□ Binder check for the first month’s premium.</p><p>□ GA disclosures for the broker and customer to review. Signature not required. </p><p>No need to return to MetLife.</p><p>For Broker □ Non-Standard Commission Agreement (if flat comp sells, please include this form).</p><p>Mail all documents to: Claremont Insurance Services, 2999 Oak Road, Suite 810, Walnut Creek, CA 94597. For assistance with open enrollment meetings and onsite application reviews, call us at 800.696.4543. </p>