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New Offerings – Information and Opt-Ins – Click the Link Below:

  • New For 2022
    • Bright Healthcare
    • Friday Health Exchange
    • Health EZ – City of Crowley Employee Plan (Johnson/Tarrant Only)
    • Superior Ambetter Value (starts 05/01/2022)
  • Networks Closed for 2022
    • Cigna Healthspring Star+Plus – All patients transitioning to Molina

New Member Applications


Physician Complete Application FY 2021–2022


AHP Complete Application FY 2021–2022

All Providers

Extra Services Interest Form

Before completing the extra service form you will need, your CP 575 Letter from the IRS and a Bank Letter or voided check.