Apply To Be A Health Plan Hero

HEALTH PLAN HERO APPLICATION

Please complete the form below to begin the application process. Once we receive your information, we will contact you with the next steps in the application process.

Not ready to apply, but have a question?  Email us at “email address.”

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Health Plan Hero Application
Name
Name
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LAST

I have read the Evaluation Criteria and believe that our plan will be competitive on the basis of the criteria. (Note: it is okay if you are not sure about some of the criteria.)

How is your company plan funded?