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1) Choose your Insurance Carrier
2) Print and fill out the form as best you can
3) Fax it back to us at 877.718.8056 (or scan/email to info@selectedbenefits.com)
4) We'll call as soon as the application comes in

Aetna Application No application fee.

Assurant Health Application $20 Application fee does apply

Blue Cross Blue Shield Application (Select Blue Advantage, Select Choice, Select Saver plans) No Application Fee

Blue Cross Blue Shield Application (HSA-Health Savings Account plans only) No Application Fee

CIGNA Healthcare Application No application fee.

Humana One Application No application fee.

United Health No application fee.


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Selected Benefits, Inc
Steven Wendlandt - Licensed Agent
5150 Broadway, Suite 202 | San Antonio 78209 Call 1-210-366-9011
Toll Free Mobile Phone Call 1-866-270-6209 | Toll Free Fax (877) 718-8056
info@selectedbenefits.com

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