Medicare Brokers - Forms and Resources
Request materials: Medicare Advantage Materials Request Form
- Individual Election Form
- Scope of Appointment
- Scope of Appointment (pdf)
- Summary of Benefits - 05/11/2023
- Evidence of Coverage - 04/17/2023
- Evidence of Coverage - MA only - updated 04/17/2023
- Senior Health Plan Star Rating - updated 10/27/2022
- Protected Health Information (PHI) Authorization Form
