Care Access Health Plan - Brokers

FAQ's Service Area

Hospital & Dental Drug Formulary Formulary Exclusions

For Brokers

LINKS AND DOWNLOADS

	Brokers Home
	Get a Quote
	Facts You Need to Know
	Broker Forms

Member Services Contact info

Monday - Friday
9:00 am - 5:00 pm

Miami-Dade County:
305-614-5050
Toll Free Number:
1-866-429-2882

Email us: info@mycareaccess.com

Marketing Department Contact Info

Monday - Friday
9:00 am - 5:00 pm

Miami-Dade County:
305-614-5004
Toll Free Number:
1-877-411-2247

Newletter

Brokers Forms

Application Forms

Broker Agent Data Form
Broker Agreement
W-9 Form

Individuals - Client Enrollment and Administration Forms

Enrollment Application Process & Checklist
Individual Enrollment Application
Credit/Debit Card Transaction Authorization Form
Electronic Fund Transfer Form
Field Underwriting Guidelines

Group of Individuals - Client Enrollment and Administration Forms

Group of Individual Application Checklist
Individual Enrollment Application
Supplemental Medical Questionnaire
Administrative Service Agreement
Field Underwriting Guidelines

Groups - Client Enrollment and Administration Forms

Group Application Checklist
Quote Request Form
Group Application and Certification Form
Group Enrollment & Status Change Form
Field Underwriting Guidelines