Client Services


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Tim Wiedman Associates
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Client Services for United Health Care
Forms for United Health Care: For additional infomation from UHC, visit their website at

The following forms are for new groups setting up their plans. These should be returned to Tim Wiedman Associates:
Employee Application (Indiana)
Employee Application (Michigan)
Employee Application 2-9 employees (Ohio)
Employee Application 10-50 employees (Ohio)
Employer Application (Indiana)
Employer Application (Michigan)
Employer Application (Ohio)

To add a new employee, or change the status (ie add/remove child, etc) for established groups, use the appropriate employee app above. After completion, fax to us at (260) 248-2558. To terminate an employee from the plan, call us at (800) 967-6205. When adding a new employee, be sure to complete the request within the time allowed for your waiting period. If you do not remember your waiting period, please contact us at (800) 967-6205.

Note: These forms are in Adobe Portable Document Format (PDF). In order to view PDF files, you will need the Adobe Acrobat Reader. The reader is available for downloading free of charge at