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Pacificare Individual Health Insurance in California
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California Well Being
Insurance Agency, LLC

#OE24618

Jerry Wetzstien
#0642830

Don La Plume
#OB07348

california health insurance plan

Pacificare of california free instant quotes for california residents.
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Call: 888-537-7948

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Medical Insurance
Pacificare Medical ~ Employer Forms
New Group Check List
Group Application
Group Acceptance/Change Application
Medical Questionnaire
Group Name Change Check List
Proprietor Statement
Workers Comp Exemption Statement
Termination
Cal-COBRA event notice
COBRA Election
Group Life
Census
   
Pacificare Medical ~ Employee Forms
Employee Enrollment
Health Statement
Change Request
Domestic Partner
Life change request
Mail Order Prescription Program
Authorization to Release Medical Records
PPO Indemnity Medical Claim
   
Pacificare Medical ~ HMO Medical Benefits
$10-30 co-pay 100%
$20-40 co-pay 500d
$10 co-pay 500d
 
$35 co-pay 600d
PC Summary Matrix
 
 
Pacificare Medical ~ PPO Medical Benefits
90-50 $250 ded
80-60 $250 ded
80-60 $500 ded

SignatureFreedom Self Directed 80-50/2000
 
Individual ~ Medical HMO Plans
Individual / Family application
Credit Card Payment Authorization*
(* 1st month only)
Evidence of coverage
Preliminary Underwriting
Plan change request
Mail Order Prescription
Individual HMO 10 
 

Dental / Vision Insurance

Pacificare Dental & Vision ~ Employer Forms

Small Group Application
Dental & Vision Employer Agreement
 
Enrollment Checklist
Proprietor Statement
Termination
   

Pacificare Dental & Vision ~ Employee Forms

   

Pacificare Dental ~ HMO Dental Benefits

HMO 140
HMO 142
HMO 144
Orthodontic Supplement
 

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Pacificare of California sets the standard in quality.

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Pacificare of California Comprehensive Network

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