Preferred Maketing Associates (PMA)
Monday - Thursday:
8 am - 4:45 pm
Friday:
8 am - 12:30 pm
Supplies
2-50 Small Group Quoting Census
            2-50 Small Group Quoting Census  (26 kb)
2-50 Enrollment Census
            2-50 Enrollment Census  (18 kb)
Level funded census
      This census is used for an initial quote.
            Level funded census  (20 kb)
2-50 Employer Application
            2-50 Employer Application  (1224 kb)
Employee Application
      Health Questions only need to be answered for level funded or 51+ group sizes.
            Employee Application  (746 kb)
ACH Form
      Need this form completed and a voided check
            ACH Form  (227 kb)
2-50 Product Portfolio
            2-50 Product Portfolio  (64 kb)
2-50 Rate Guide
      Make sure you click on correct tab at bottom of attachment for correct plan.
            2-50 Rate Guide  (108 kb)
51+ Product Portfolio
      This is the product portfolio for 51+ groups. Also they are able to customize benefits for any group to suit their needs.
            51+ Product Portfolio  (37 kb)
Large Group Master Application
      This app must be submitted with any group 51+ to start the quoting process. Must be dated within 90 days of effective date.
            Large Group Master Application  (330 kb)
Census Template
      This is the census for a quote request for 51+ groups.
            Census Template  (29 kb)
Large Group (51+) Quoting Requirements
            Large Group (51+) Quoting Requirements  (2106 kb)
Large Group Enrollment Census
            Large Group Enrollment Census  (143 kb)
2021 Formulary Drug List
            2021 Formulary Drug List  (2225 kb)
2021 Preventive Drug List
            2021 Preventive Drug List  (618 kb)
Broker Admin Guide
            Broker Admin Guide  (247 kb)
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