Preferred Maketing Associates (PMA)
Monday - Thursday:
8 am - 4:45 pm
Friday:
8 am - 12:30 pm
Supplies
            BCBS Med Supp App 10-16-18 REV  (20051 kb)
            BCBS Med Supp Household Discount Guidelines 1-1-2019  (13 kb)
            BCBS Outline of Coverage (Rates) April 1, 2019 to March 31, 2020  (1563 kb)
The AOR form must be submitted with an underwritten application.
            BCBS Med Supp AOR Form (8-6-2018)  (79 kb)
            BCBS Med Supp Debit Auth Form (2-13-19)  (714 kb)
            BCBS (EMPLOYER) Med Supp Debit Auth Form (1-7-19)  (557 kb)
2019 - BCBS Dental Essentials Brochure - Rates
            2019 - BCBS Dental Essentials Brochure - Rates   (846 kb)
            Stand-alone Dental Application  (703 kb)
      Please submit with all Medicare Supplement Applications
            Medicare Card Form  (32 kb)
            2018-2019 Medicare Supplement Outline of Coverage with Rates   (2055 kb)
            2018 Medicare & You   (4696 kb)
            2017 Choosing a Medigap Policy  (850 kb)
            Medicare Supplement Replacement Form  (42 kb)
      This form is used for Medicare Supplement or Over 65 Dental plans ONLY.
            Bank Account or Address Change Form  (202 kb)
            Effective Date Form  (32 kb)
            Cancellation Form  (74 kb)
            PHI Release Form  (145 kb)
            BCBS Reinstatement Form (1-31-2018)  (702 kb)
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