Flyers and Documents
Medicare Forms and Flyers
- HF Enrollment Form, CVRS.pdf
- HF Plan Selection Form.pdf
- HF Disenrollment Form.pdf
- HF Scope of Appointment Form.pdf
- AH Enrollment Form, SS.pdf
- AH Disenrollment Form.pdf
- AH Scope of Appointment Form.pdf
- Enrollment Instructions Flyer.pdf
- Premium Payment Options Flyer.pdf
- Network Guide Map.pdf
- Silver & Fit Welcome Flyer.pdf
- Silver & Fit Program Flyer.pdf
- Coordination of Benefits Form.pdf
- Appointment of Representation Form.pdf
- Enrollment Instructions.pdf
- Plan Selection Form, CVRS.pdf
- Enrollment Request Form, CVRS.pdf
- Enrollment Request Form, SunSaver.pdf
- Disenrollment Form.pdf
- Scope of Appointment.pdf
- Coordination of Benefits Form.pdf
- Network Sales Map.pdf
- Silver & Fit Welcome Flyer.pdf
- Silver & Fit Program Flyer.pdf
- Premium Payment Options Flyer
Individual Forms and Flyers
- HF IFP Application.pdf
- HF IFP Application_SPANISH
- HF IFP Change Termination Form
- HF IFP Change Termination Form_SPANISH
- HF IFP SEP Attestation Form
- HF IFP SEP Attestation Form_SPANISH
- Premium Payment Options Flyer
- Active & Fit Welcome Flyer
- Pediatric Dental-Vision Flyer
- Appointment of Representation Form
- Sample Renewal Letter OFF Market Discontinued
- Sample Renewal Letter On Market Discontinued
- Sample Renewal Letter OFF Market
- Sample Renewal Letter On Market
- Comparison of Benefits
- Crosswalk
- OFF Market Application (Email completed OFF Market application to [email protected])
- OFF Market Application - Spanish
- Change/Termination(Email completed Change/Term form to [email protected])
- SEP Attestation (Email completed SEP Attestations to [email protected])
- SEP Attestation - Spanish
- Steps to Begin
- Premium Payment Options
- Active & Fit Program Flyer
- Active & Fit Welcome Flyer
- Network Sales Map
- Why Choose Health First Health Plans
- High Value Network
- Pediatric Dental Vision
- Preventive Benefits
- Pharmacy Benefits
- Urgent Care
- FL Dependent Age Law
Individual Schedules of Benefits
Please email [email protected] to request any 2022 Schedule of Benefits
Bronze 1750 SP
Bronze 1750
Bronze 1774 SP
Bronze 1774
Bronze 1826 SP
Bronze 1826
Bronze Gym Access 1656 SP
Bronze Gym Access 1656
Bronze Gym Access 1796 SP
Bronze Gym Access 1796
Bronze Gym Access HSA 1658 SP
Bronze Gym Access HSA 1658
Bronze HSA 1794 SP
Bronze HSA 1794
Bronze Savings 1820 SP
Bronze Savings 1820
Bronze Standard 1827 SP
Bronze Standard 1827
Bronze Standard 1828 SP
Bronze Standard 1828
Bronze Value 1814 SP
Bronze Value 1814
Catastrophic Gym Access 1746 SP
Catastrophic Gym Access 1746
Gold 1770 SP
Gold 1770
Gold Gym Access 1736 SP
Gold Gym Access 1736
Gold Gym Access 1740 SP
Gold Gym Access 1740
Gold Gym Access 1742 SP
Gold Gym Access 1742
Gold Gym Access HSA 1744 SP
Gold Gym Access HSA 1744
Gold Savings 1825 SP
Gold Savings 1825
Gold Standard 1833 SP
Gold Standard 1833
Gold Value 1819 SP
Gold Value 1819
Silver 1806 SP
Silver 1806
Silver AV73 1807 SP
Silver AV73 1807
Silver AV87 1808 SP
Silver AV87 1808
Silver AV94 1809 SP
Silver AV94 1809
Silver Gym Access 1664 SP
Silver Gym Access 1664
Silver Gym Access 1688 SP
Silver Gym Access 1688
Silver Gym Access 3704 SP
Silver Gym Access 3704
Silver Gym Access AV73 1665 SP
Silver Gym Access AV73 1665
Silver Gym Access AV73 1689 SP
Silver Gym Access AV73 1689
Silver Gym Access AV87 1666 SP
Silver Gym Access AV87 1666
Silver Gym Access AV87 1690 SP
Silver Gym Access AV87 1690
Silver Gym Access AV94 1667 SP
Silver Gym Access AV94 1667
Silver Gym Access AV94 1691 SP
Silver Gym Access AV94 1691
Silver Savings 1821 SP
Silver Savings 1821
Silver Savings AV73 1822 SP
Silver Savings AV73 1822
Silver Savings AV87 1823 SP
Silver Savings AV87 1823
Silver Savings AV94 1824 SP
Silver Savings AV94 1824
Silver Standard 1829 SP
Silver Standard 1829
Silver Standard AV73 1830 SP
Silver Standard AV73 1830
Silver Standard AV87 1831 SP
Silver Standard AV87 1831
Silver Standard AV94 1832 SP
Silver Standard AV94 1832
Silver Value 1815 SP
Silver Value 1815
Silver Value AV73 1816 SP
Silver Value AV73 1816
Silver Value AV87 1817 SP
Silver Value AV87 1817
Silver Value AV94 1818 SP
Silver Value AV94 1818