Visitors since 2015
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Phone: 813-434-1902
Fax: 813-434-2322
email:
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Client Services
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Forms
Forms available for download or print by clients and agents
Member Services (Florida) 888-200-0405
Claims 877-842-3210
Dental 877-816-3596
Vision 800-638-3120
Rx 800-356-3477
HSA Eligable Plans 800-523-5800
Long Term Care Questionnaire
Basic information to get started on a quote
ltc.questionnaire-6-2020-fillable.pdf
Adobe Acrobat document [2.0 MB]
Basic information to get started on a quote
ltc.questionnaire-6-2020-fillable.pdf
Adobe Acrobat document [2.0 MB]
Network Search
Philadelphia American Forms
Gold + Application
This can be taken over the phone by your agent. You can use this as a guidline to answer the questions.
HSP GOLD Application AP.FL.pdf
Adobe Acrobat document [66.5 KB]
This can be taken over the phone by your agent. You can use this as a guidline to answer the questions.
HSP GOLD Application AP.FL.pdf
Adobe Acrobat document [66.5 KB]
Gold + Outline of Coverage
This describes what the coverage options for the Gold + plan.
HSP GOLD Outline of Coverage OC.FL.pdf
Adobe Acrobat document [34.6 KB]
This describes what the coverage options for the Gold + plan.
HSP GOLD Outline of Coverage OC.FL.pdf
Adobe Acrobat document [34.6 KB]
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