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Broker Links Documents and Forms |
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General Information |
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2011-12 Underwriting
Guidelines PHT Broker Administrative Guide
(971) 255-5359 or quotes@pacifichealthtrust.com |
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RFP Forms |
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Group Health Risk
Questionnaire |
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New Group Forms |
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PHT Joinder Agreement (Indenture) Late Submission Application/Letter (Required if submitted after the 20th) HN Ongoing Care Form (Optional)
BSI COBRA Administrative Agreement (if Applicable) BSI CDHP Cafeteria Plan Adoption Form (If Applicable) BSI CDHP Group Enrollment Forms (If Applicable) BSI CDHP Employee Enrollment
Form (if Applicable)
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Renewal Forms |
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2010 Pacific Health Trust |
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