Preferred Maketing Associates (PMA)
Monday - Thursday:
8 am - 4:45 pm
Friday:
8 am - 12:30 pm
Supplies
            2018 Nebraska Application  (612 kb)
            2018 Nebraska Change Application  (464 kb)
            Plan Change Form Tip Sheet  (287 kb)
      Please complete for all On-Market applicants.
            2018 AOR Form  (91 kb)
            Payment Options Form  (162 kb)
            Policy Term Form  (343 kb)
      Note: Gold Copay Plus is not available to individuals and families living in Buffalo, Burt, Butler, Cass, Colfax, Cuming, Dodge, Douglas, Fillmore, Hall, Johnson, Lancaster, Nance, Nemaha, Nuckolls, Otoe, Pawnee, Saline, Sarpy, Saunders, Seward, Thayer or Washington county.
            2018 NE Medica Insure Rate Guide  (758 kb)
            2018 NE Medica with CHI Rate Guide  (693 kb)
            2018 IA Medica Insure Rate Guide  (920 kb)
            2018 IA Medica with CHI Rate Guide  (580 kb)
            2018 IA Inspire by Medica Rate Guide  (860 kb)
            2018 NE Product Brochure  (736 kb)
            2018 NE Plan Comparison  (173 kb)
            2018 IA Product Brochure  (1617 kb)
            2018 IA Plan Comparison  (321 kb)
            2018 Insure Network Sell Sheet  (1247 kb)
            2018 CHI Network Sell Sheet  (1469 kb)
            2018 Inspire by Medica Network Sell Sheet  (1399 kb)
            2018 KS Medica Connect Rate Guide  (836 kb)
            2018 KS Select by Medica Rate Guide  (587 kb)
            2018 KS Product Brochure  (895 kb)
            2018 KS Plan Comparison  (170 kb)
            2018 Medica Connect Network Sell Sheet  (2312 kb)
            2018 KS Select by Medica Network Sell Sheet  (2084 kb)
            Continuity of Care Request  (662 kb)
            2017 NE Medica Insure Product Brochure  (6258 kb)
            2017 NE Rate Guide  (691 kb)
            2017 SEP Guide  (103 kb)
            Medical Claim Form  (1069 kb)
            Prescription Claim Form  (103 kb)
            2017 IA Medica Insure Product Brochure  (5070 kb)
            2017 IA Rate Guide  (822 kb)
            Health Advocate Flyer  (417 kb)
            Nurse Line Flyer  (712 kb)
            Healthy Living Flyer  (559 kb)
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