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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


Doctors

Physician Complete Application FY 2021–2022

Mid-Levels

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.