- IFP Individual and Family Major Medical Health Insurance Application - Customer completes an IFP- Individual and Family Major Medical Health Insurance Application. A completed "Health Insurance Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online.: $25.00 USD
- SG- Small Business Health Insurance Employer Submitted Application - Employer completes a Small Business Group Health Insurance Application. A completed "Health Insurance Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online.: $37.50 USD
- ST- Short Term Health Insurance Application - Customer completes a Short Term Health Insurance Application. A completed "Health Insurance Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online.: $5.00 USD
- STU- Student Health Insurance Application - Customer completes a Student Health Insurance Application. A completed "Health Insurance Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online: $10.00 USD
- DT- Dental Insurance Application - Customer completes a Dental Insurance Application. A completed "Dental Insurance Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online.: $5.00 USD
- Qualified Health Plan Application - Customer completes a Qualified Health Plan Application. A completed "Qualified Health Plan Application" is defined as a Customer that (i) properly completes an online application, and (ii) clicks "submit" or a similar button required to submit the application online.: $25.00 USD
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