RESOURCE CENTER

Installation Forms
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2016 IHC Enrollment Conversion Form
To be used for all individuals making plan changes. Please remember existing members accepting their soft conversion (mapping) from Advance to Omnia plans do not need to submit an application.
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01.09.2013
Automatic Pay Plan Application
Agreement needed to be completed by member if they wish to have direct debit for their initial premium payment. It is not intended for continuous monthly premium payment and ONLY for initial monthly payment.
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01.09.2013
Application for Individual Coverage
Non-Group enrollment/change request form, to be used by prospect who wishes to apply for, make a change to, or cancel from one of Horizon's individual health plans (created 7/10)
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