Skip to ContentSkip to Footer

Policy Change Request

The following form is provided to you for making changes or requests on your existing policies. By submitting this form you understand that no coverage or premium adjustment of any kind is bound until you receive written notice from us.

Policy Change Request

* indicates required fields

General Information

Current Insurance Information

MM slash DD slash YYYY
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

We Want Your Opinion!
Customer Reviews
Rated 5 out of 5

Great customer response and assistance. Continues to update me on outstanding...

CR
Curtis R
Rated 5 out of 5

They are the best !!! None better they have gone out of their way to help me...

B
bstewbeav
Rated 5 out of 5

LOVE LOVE LOVE Health Planning Associates!!! They have been our Employee...

Lydia Gunn
Lydia G
Rated 5 out of 5

Alysia is so very helpful every time I call. She is very responsive and gets...

MM
Macy M
Rated 5 out of 5

Alysia Long, a Group Claims Specialist w/ Health Planning, has gone above and...

DW
Donald W