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Our commitment to enhancing your marketing efforts is evident in our ongoing development and refinement of the Marketing Tool Library. We strive to equip you with the most effective resources for successful campaigns.
We understand the importance of having quick and easy access to essential forms and links to efficiently conduct business and assist your clients.
For more information or questions on materials, call us at 800-964-8331. We want to hear from you!
Below you will find a list of important forms used with marketing plans through Healthy America including the Effective Date Schedule, Group Billing Forms and more. If you have any questions about these forms, you can contact us at 800-964-8331.
indicates most commonly used forms and links.
We are dedicated to keeping our marketing materials current and relevant. This section will see regular updates with the most recently approved forms and links. It is crucial that you always utilize the lastest versions to ensure accuracy and compliance in your marketing strategies.
Notification of Updates: Whenever a material is updated, we will send an email notification. It's important to transition to the updated material promptly to maintain consistency and effectiveness in your marketing efforts.
| Form Name | Form Link  |
|---|---|
| Effective Date Schedule (Shows Effective Date & Draft Date) |
EFFECTIVE DATE SCHEDULE |
| Claim Forms (Links to all Plan Claim Forms) |
CLAIM FORMS |
| Group Billing Form (For Groups with Same Billing Account) |
GROUP BILLING FORM |
| Cancellation Request Form (Client Form to cancel membership plans) |
MEMBER CANCELLATION FORM |
| Bank Draft Change Form (Update UBA or HAA Billing info) |
BANK DRAFT CHANGE FORM |
| Credit Card Change Form (Update UBA or HAA Billing info) |
CREDIT CARD CHANGE FORM |
| Add Dependent Form (Add members to a plan) |
ADD DEPENDENT FORM |
| Request Additional Customer ID Cards (Replace lost or get additional ID cards for member) |
REQUEST ADDITIONAL ID CARDS |
| Submit Renewed Licenses (Update expired licenses to ensure our system is updated) |
SUBMIT EXPIRING LICENSES |
| Agent Back Office (Access New Business & Renewal Statement) |
EAGENTCENTER.COM LOGIN |
| Change Client Address Form (Change Customer mailing address) | CHANGE CUSTOMER MAILING ADDRESS |
| Change Client Email Address Form (Update Customer email address) | CHANGE CUSTOMER EMAIL ADDRESS |
| Vitamin Order or Reorder Form (Use if member's have FREE vitamins in plan - order form also available on Member Portal) | VITAMIN ORDER FORM |
| Paramount RX Retail Web Tool (Look up RX providers & discounts) | PARAMOUNT RX RETAIL WEB TOOL |
| Paramount RX Pet Web Tool (Look up Pet RX providers & discounts) | PARAMOUNT PET RX WEB TOOL |
| Secure Email Upload (Send documents to us securely using our Sharefile link) | SEND DOCUMENTS SECURELY THROUGH SHAREFILE |
| Agent Direct Deposit Change Form (Change the account for your direct deposit checks) | AGENT CHANGE OF THEIR DIRECT DEPOSIT INFO |
| CMS Consent Form (Agent for Marketplace ACA sales for Customer permission) | CMS CONSENT FORM |
| SiriusPoint Appointment Paperwork (Stand-alone appointment form for Sirius) | SIRIUS APPOINTMENT FORM |
| GTL Appointment Paperwork (Stand-alone appointment form for GTL) | GTL APPOINTMENT FORM |
| US Fire / Crum & Forster Appointment Paperwork (Stand-alone appointment form for USFire/C&F) | US FIRE / C&F APPOINTMENT FORM |
| UBA & HAA Help Guide (Commonly asked questions about UBA & HAA plans) | UBA & BB HELP GUIDE |
| United Healthcare Agent Portal (Login to your United Healthcare Agent Portal) | UNITED HEALTHCARE AGENT PORTAL LOGIN |
For additional information or any questions about these materials, feel free to reach out to us at 800-964-8331. We are eager to hear from you and are here to support your marketing endeavors. Your feedback is invaluable in helping us improve our offerings and better serve your needs.