GEORGE E DANIEL JR
Authorized Agent

 
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George E Daniel Jr
www.danielhealthinsurance.com
119 Donalson Street
Bainbridge, Georgia   39817
 
Phone   229-246-3342
Fax      229-246-3342
Cell     229-416-7030
dan@danielhealth.com
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      Symetra Term Life

      Symetra Universal Life

   welcome.jsp
 
 
Welcome by - George E Daniel Jr     

Forms & Brochures

These Applications, Forms & Brochures are in PDF format. In order to view and print these brochures you must have Adobe Acrobat Reader. This software is available for FREE from the Adobe Acrobat Web Site, click the "Get Acrobat Reader" below to obtain your copy. Always make sure to download the most current version of Acrobat Reader.

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NEW! Online Quoting -   Click Here for Quotes         
PPO - To find a provider, click  Find a Doctor 
Medical Insurance - Forms & Applications

 

BCBS - Bank Draft Form - Electronic EFT

PHI - Agent Change Form - HIPPA

PHI - Personal Health Information - HIPPA

Request for Underwriting Opinion

Blue Value & Select & Right Plan Application

Member Authorization Form

Change Request

Medical Claim Form
 
Short Term Medical Insurance

Short Term Brochure

Short Term Application

Short Term Medical Application (Paper)

 
Short Term Medical Insurance

Short Term Medical Insurance - Assurant

 

 

 
Dental & Vision & Life

Blue View Vision 2009 Brochure

Blue View Vision Claim Form for Reimbursement

Vision Claim Form - Avesis - Older Form

Term Life Premiums 

Dental Premiums

Senior Dental Application

Senior Dental Brochure
 
Misc

Member Home

Customer Service

PPO Member Guide

Download Forms

Bank Draft Form

& Vision & Life
 
Individual Agent Sales Tools
Form #
Revised
Individual Marketing Assistance Program (MAP)
N/A
N/A
Agent Data Entry
N/A
N/A
2010 Individual Member Billing Schedule
N/A
N/A
Agent of Record Policy for Individual Plans 
N/A
01/09
Agent of Record Change Form
N/A
N/A
Benefit Summaries for Individual Business 
N/A
N/A
Product Codes 
N/A
N/A
County Codes
N/A
N/A
Georgia Agents Guide 
N/A
11/09
Product Movement Guide 
N/A
10/08
Individual Product Medical Questionnaires
N/A
N/A
Individual Products Agreement for List Bill
9616
09/03
Certification of Dependency
N/A
N/A
Applications and Forms
 
 
Individual Products Change Form
N/A
10/02
Individual Products Automatic Draft Request
N/A
06/06
Chase HSA Application
N/A
11/07
NEW!! Short Term Medical Enrollment Application
N/A
02/09
Agents/Brokers Electronic Funds Transfer Form
N/A
N/A
General Member Authorization Form Instructions
N/A
12/03
General Member Authorization Form
N/A
12/03
Conditioned Authorization Form - Instructions
N/A
12/03
Conditioned Authorization Form
N/A
12/03
Broker Co-op Advertising Program (BCAP) Agreement Form
N/A
N/A
Broker Co-op Advertising Program (BCAP) Reimbursement Form
N/A
N/A
Underwriting Opinion Form 
N/A
07/08
GGL Beneficiary Change Form
N/A
11/02
Individual Products Enrollment Application
N/A
08/09

United Home Life Insurance

Guaranteed Issue Whole Life Insurance
Term Life Insurance Brochure
The Provider Life Insurance
Total Protector Whole Life Brochure
Whole Life Application
 
 
Specialty
Form #
Revised
Dental
 
 
Sales Brochure
 
 
Individual and Family Dental Brochure 
N/A
09/06
Applications and Forms
 
 
Individual and Family Dental Application
N/A
N/A
SmileNet Enrollment Application
N/A
N/A
Life and Disability
 
 
Term Life Sales Slick with Rates
MGASH3743GEN
08/08
Applications and Forms
 
 
Individual Term Life Application
10574
11/04

Michelle Hill - Manager II Sales Support 866-215-4879 mhill@bcbsga.com

Commissions

Sharon Vernon - Mgr II Financial Ops Dept 804-354-7077 sharon.vernon@anthem.com

Chase Donner - Financial Operations Analyst

Sr. 404-842-8791 877-230-6364 Charles.Donner@wellpoint.com

Stacey Wimberley 404-842-8723 877-230-6364 stacey.wimberley@bcbsga.com

Marketing and Co-op Advertising Program

Joe LaDore - Marketing Manager - East Broker

Mktg 203-239-8406 Joe.LaDore@anthem.com

Individual Contract Sales

Tom Snow - Individual/Broker Sales Mgr 404-467-2923 404-842-8085 404-831-4282 walter.snow@wellpoint.com

Marc Capogrossi - Reg Sales Mgr Ind Sales -

N GA & Statewide

404-313-9232 404-842-8085 marc.capogrossi@bcbsga.com

Lynn Daniels - Reg Sales Mgr Individual Sales

- Statewide

404-520-5969 404-842-8085 ldaniels@bcbsga.com

Angalique Johnson - Reg Sales Rep -

Individual - Col/Alb & GFB

404-923-3143 404-842-8085 angalique.whitmore@bcbsga.com

Monica Byers - Reg Sales Rep - Individual -

Statewide

404-842-8812 404-842-8085 monica.byers@wellpoint.com

Christopher Mele - Reg Sales Rep - Individual

- Statewide

404-842-8068 404-842-8085 christopher.mele@wellpoint.com

Lori Calta - Sales Assistant 404-923-3146 404-842-8085 lori.calta@bcbsga.com

Life Products

Donald Jackson 404-923-3242 dtjackson@bcbsga.com

 


 

 
 Blue Cross and Blue Shield of Georgia is an independent licensee of the Blue Cross and Blue Shield Association
 Office Hours - 8:00 AM to 11:00 AM M-F and other times by appointment