Individual Agent?
Already Registered?



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

Enrollment Application (English)
Medical Records Release Authorization Form
Electronic Funds Transfer (EFT) Authorization
New Application Fax Cover
Underwriting Fax Cover

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
HIPAA Kit Letter
HIPAA Questionnaire

Value Added Beneftis
VISTA Laser Care
HEARx Discount





© Vista HealthPlan All rights Reserved