Family and Individual Health Insurance Forms

Altius | Assurant | Humana | Regence Blue Cross Blue Shield | Select Health

Altius

• Application

• Cancellation Form

• Enrollment Booklet

• Formulary List (Alphabetical)

• Formulary List (Tiered)

• Provider Directory

• Rates (3rd Quarter)

Assurant

• Application

• Automatic Payments Forms

• Cancellation Form

• Change Form

• Choosing the Right Health Plan Brochure

• CoreMed Elite Brochure

• Credit Card Authorization (First Payment Only)

• Credit Card Authorization (One-time)

• Credit Card Authorization (Recurring)

• Elite Portfolio Brochure

• HSA Elite Plans Brochure

• MaxPlan Elite Brochure

• Preffered rating Questionaire

• RightStart Elite Brochure

• SuiteSolutions Brochure

• SuiteSolutions Rates

Assurant Student Select

• Brochure and Application

• Cancellation Form

Humana

• Account Change Form

• Address Change Form

• Agent of Record Letter

• Auto Withdraw Setup Form

• Autograph Share 70 & Rx

• Autograph Share 80-HSA

• Autograph Share 80 & Rx

• Autograph Total-HSA

• Autograph Total & Rx-HSA

• Cancellation Form

• Monogram Total & Rx

• Policy Change / Review Form

• Portrait Share 80 Unlimited & Rx

• Renewal Change Form

Regence Blue Cross Blue Shield

• Address Change Form

• Agent of Record Letter

• Application

• Auto-withdraw Setup Form

• Cancellation Form

• Individual Health Questionnaire

• Newborn Addition

• Plan Compare Brochure

Select Health

• Agent of Record Letter

• Application

• Application (Fill-in)

• Bank Account Change Form

• Benefit Summary

• Cancellation Form

• Change Form

• Outline of Coverage

• Reapplication

• Sales Packet

Select Health Kids Plan

• Agent of Record Letter

• Application

• Bank Account Change Form

• Benefit Summary

• Cancellation Form

• Change Form

• Sales Packet

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