Download Brochures & Applications for Arizona Plans

Links for Arizona plan descriptions, paper and online applications and medical providers.

Many of the links below contain files or forms that are in Adobe Acrobat Format (PDF files). Many of the documents will only open with the latest version of Acrobat Reader from Adobe Systems. If you don't already have the latest version, click on the yellow "Get Acrobat Reader" image to download the free program.

Or please feel free to call us at 800-600-9663 or 520-760-0392 to request any package be sent to you via the US Mail or as an email attachment PDF file.

1. Aetna Brochure and Application [PDF file]
   
2. Aetna Application [PDF file]
   
3. Providers for Aetna Policyholders
   
   

   

4. Assurant Short Term Policy Paper Application [PDF file]
   
5. Apply online for an Assurant Short Term Health policy
   
   
6. Assurant Long Term Policy Paper Application [PDF file]
   
7. Assurant Long Term Brochure [PDF file]
   
   
   

   

8. Click here for the Blue Cross Blue Shield of Arizona Paper Application [PDF file]
   
9. Apply online for a Blue Cross Blue Shield of Arizona policy
   
10. Click here for ONLY the Blue Cross signature page [PDF file]
    
11. Blue Cross Blue Shield of Arizona Rate Sheet [PDF file]
    
12. Blue Cross Blue Shield of Arizona Automatic Bank Draft (Sure Pay) form [PDF file]
    
13. Click here for the Blue Cross Blue Shield of Arizona Agent of Record Change Form (AOR form) [PDF file]
    
14. Click here for the Blue Cross Blue Shield of Arizona ASSOCIATION (AAA and Chamber of Commerce) Broker of Record Change Form (AOR form) [PDF file]
    
    
15. Blue Cross Blue Shield of Arizona BlueEssential Plus PPO description [PDF file]
    
16. Blue Cross Blue Shield of Arizona BlueValue Plus PPO description [PDF file]
    
17. Blue Cross Blue Shield of Arizona BlueOptimum Plus PPO description [PDF file]
    
18. Blue Cross Blue Shield of Arizona BluePortfolio Plus HSA PPO description [PDF file]
    
    
19. Blue Cross Blue Shield of Arizona Medicare Supplement Brochure [PDF file]
    
20. Blue Cross Blue Shield of Arizona Medicare Supplement Application [PDF file]
    
21. Blue Cross Blue Shield of Arizona "HIPAA/Portability" plan brochure and application [PDF file]
    
22. Blue Cross Blue Shield of Arizona Prescription Medication Guide [PDF file]
    
23. Providers for Blue Cross Blue Shield of Arizona
    
24. Blue Cross Blue Shield of Arizona Urgent Care Center Providers [PDF file]
    
25. Out of state providers for Blue Cross Blue Shield of Arizona (for when you're traveling)
    
26. Blue Cross Blue Shield of Arizona brochure explaining your benefits when you're away from home [PDF file]
    
    
    
    

    

27. Click here to apply online for a Celtic policy
    
28. Providers for Celtic
    
    
    

    

29. Cigna HMO description [PDF file]
    
30. Cigna PPO description [PDF file]
    
31. Cigna application [PDF file]
    
32. Click here to apply online for a Cigna policy
    
33. Providers for Cigna
    
    
    

    

34. Delta Dental Individual Plan Matrix [PDF file]
    
35. Providers for the Delta Dental Service plan [PDF file]
    
36. Application for the Delta Dental Individual Plan [PDF file]
    
37. Apply online for a Denta Dental policy
    
    
    

    

38. Employers Dental Service plan - brochure and application [PDF file]
    
39. Providers for the Employers Dental Service plan [PDF file]
    
40. Form to give your dentist to become a provider for the Employers Dental Service plan [PDF file]
    
41. Providers for EDS Dental
    
    
    

    

42. Click here for United HealthCare's Golden Rule brochure [PDF file]
    
43. Click here for United HealthCare's Golden Rule application [PDF file]
    
44. Click here to apply online for a United HealthCare Golden Rule policy
    
45. Providers for United HealthCare's Golden Rule plans
    
    
    

    

46. Click here for the Health Net application [PDF file]
    
47. Health Net's PPO brochure and rates (for people UNDER the age of 65) [PDF file]
    
48. Health Net's HMO brochure and rates (for people UNDER the age of 65) [PDF file]
    
49. Health Net's HSA brochure and rates (for people UNDER the age of 65) [PDF file]
    
50. Health Net's Dental and Vision brochure and rates (for people UNDER the age of 65) [PDF file]
    
51. Health Net "HIPAA/Portability" plan brochure [PDF file]
    
52. Providers for Health Net
    
    
    

    

53. Apply online for a Humana One individual health insurance policy
    
54. Humana Medicare Supplement A-F Plans brochure [PDF file]
    
55. Humana Medicare Supplement GOLD Plan brochure [PDF file]
    
56. Providers for Humana
    
    
    

    

57. Height/Weight Guidelines for Blue Cross [PDF file]
    
58. Medical Underwriting Guidelines for Blue Cross of Arizona [PDF file]
    
59. Group Census/Quote Request Form [PDF file]
    
60. Group Health History Form [PDF file]
    
61. Lehrman Group INDIVIDUAL "Agent of Record" Form [PDF file]
    
62. Lehrman Group GROUP "Agent of Record" Form [PDF file]
    
63. Blue Cross of Arizona Individual "Agent of Record" Form [PDF file]
    
64. Medicare Benefit Comparisons [web page]
    
65. Target's $4 Generic Drugs List [PDF file]
    
66. WalMart's $4 Generic Drugs List [PDF file]
    
    
    

    

67. Liaison International Health Insurance information and application [web page]
    
    
    

    

68. Click here for PCIP (Pre-existing Condition Health Plan brochure and application [PDF file]
    
    

    

69. Click here for United HealthCare's Golden Rule health insurance brochure [PDF file]
    
70. Click here for United HealthCare's Golden Rule application [PDF file]
    
71. Click here for United HealthCare's Golden Rule HIPAA application [PDF file]
    
72. Click here to apply online for a United HealthCare Golden Rule policy
    
73. Providers for United HealthCare's Golden Rule plans
    
74. Click to apply online for United HealthCare dental plan
    
75. Click for United HealthCare dental brochure