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SECURE DENTALONE APPLICATION - Print off this application or go under "Related Links" to apply online. SECURE DENTALONE BROCHURE - Secure DentalOne offer 3 plans! Available to individuals or small businesses! Apply online (go under RELATED LINKS) or print off the paper application.
Application - Complete and call our office for additional instructions. PPO 1500 - $1500 Deductible PPO Plan PPO 2500 - $2500 Deductible PPO Plan PPO 500 - $500 Deductible PPO Plan Value Plan - $2000 Deductible - Most popular PPO plan!
Lab Result Request - AIG uses Clinical Reference Lab for processing your lab work. Fax this form to receive your report quickly.
Agent of Record - Let us help you through claims or policy questions, rate increases and making changes to your policy at NO COST TO YOU! Print off and fax this form for immediate service! (Must have had your BCBS policy for 12 months.) Application & Change Form - Health - Paper App (not for employer/employee use) for faxing or mailing. Call our office for processing instructions. Bank Draft - Set up bank draft or change your current draft. (One is included with the application.) Brochure - HSA Compatible Plans - High deductible plans that your CPA has recommended for tax savings! Brochure - Tonik PPO Plan - Newest plan for young adults who live life to it's fullest. Includes dental and vision benefits! Dental - Brochure - Monthly Rates: Individual $27 Family $76 Dental Application - Use only if adding dental to your current heath plan OR if applying for dental without a current health plan. Medicare Supplement App - Med Supp App for individuals 65 years and older. Medicare Supplement Brochure - For 65+ individuals with Medicare Parts A & B. Short Term Medical Application - Faxable application for immediate short term plan. Short Term Medical Brochure & Rates - Immediate coverage up to 12 months. Vision for Singles or Families - New VISION PLAN only $10 for single policyholders or $24 for the entire family! Vision Information - Detailed info about how the Vision Plan works.
Application - Simply print, complete and fax to 770-967-0372. Call us if any questions at 770-967-1111. Business Bank Draft Verification - Required with application if bank draft is set up for a business account. Dental Benefits Brochure - Dental benefits included in the CoventryOne health plan for individuals and families. Dental Benefits Schedule - Find out how much you will pay for specific procedures. Health Plans Grid - Side-by-side comparison of each individual health plan. Rx Preauthorization Form - To be completed by your physican for all Rx requiring preauth. Vision Benefits Brochure - Vision benefits included in the CoventryOne plan for individuals and families.
Application - Health app for faxing. Call office for more info. HSA Brochure - Complete booklet on how the HSA plan works.
Brochure - Portrait Plan (BEST!) - The personal health plan with concierge-level service and benefits you’d expect from big employers. Brochure Comparison - Quick look at the three basic plan structures... Portrait, Autograph and Monogram.
Application - Complete and fax to our office at 770-967-0372. We'll take it from there! Balance Plan Brochure & Rates - Basic HMO Plan - Very cost effective. Has no maternity. HMO Plans Brochure - Learn more about GA's only HMO plan available to individuals that includes MATERNITY! HMO Rates - Rates for effective date of Oct., Nov., or December 2008. HSA Plans Brochure - New High Deductible Plans offering tax advantages.
Application - Application for faxing. Call office for more info. HSA Brochure - Complete HSA booklet. United Healthcare is affiliated with Golden Rule.
