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New Agent Registration
Agent Address Change Form

Individual HMO Product Guide
Z Plan Product Placemat
Focused Deductible Product Placemat
Coinsurance Product Placemat
Individual Plans Summary Of Benefits
Maternity Riders

Individual Focused Deductible Z Plan Rates
Individual HMO and Open Access Rates
Individual PPO Rates

Enrollment Application (English)
Enrollment Application (Spanish)
Medical Records Release Authorization Form
Electronic Funds Transfer (EFT) Authorization

HIPAA Indvidual Sales Kit
HIPAA Authorization Form - VHP & VSF
Guideline for when a HIPAA Authorization Is Required
Instructions for Completing a HIPAA Authorization Form
Sample Completed Authorization Form

Value Added Beneftis
VISTA Laser Care
HEARx Discount





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