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Access and download forms and resources for your clients. Don’t hesitate to contact us if you need assistance.
Administrative Quick Guide (English)Member Enrollment, Termination, Change & Waiver Form (English)Master Group Application (English)Renewal Change Form (English)
You can also download large group plan documents.
Completed forms may be faxed directly to our Enrollment Department at 541-768-9778 or emailed to [email protected].
It is expected that the agent’s received date(s) for the completed enrollment form and completed scope of appointment form each be documented on the forms in order to be compliant.
The following plan documents are available to help you serve your clients interested in our Samaritan Advantage plans and can be used to complete an enrollment information guide.
See details on our Benefits Mastercard and Rewards & Incentives Program:
To find a dental provider, choose any dental provider who has not opted-out of participating in Medicare programs. Review CMS Opt-Out List.
Can’t find what you’re looking for? Search our document library.
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