Apply online application CA Arizona health insurance individual medical plan

Form Center (access to applications)
Click below to download applications and forms for all major Arizona health insurance carriers.  You will need acrobat's free.  These are large files so please wait a few minutes for the file to appear.

  Applications (download)

here for full form download listing

      Apply Online
   cuts processing time in half
       Blue Cross® Blue Shield® of Arizona
       Health Net of Arizona
       LifeWise of Arizona
       Humana of Arizona
       Golden Rule of Arizona


Instantly quote and compare major carriers
Best rates available - same as carrier direct

Solid advice to choose the best plan for YOU 

Online applications cut time in half

To Expedite Processing

We just need the completed application and first payment by check or credit card (when available)  to start the process.  You can expedite processing by faxing copies of this information to us at
866/394.8320.   Make sure to give yourself enough time to go through the process for your ideal effective date.  Questions on enrollment here

Please call us or e-mail us with any questions.  We are here to help.  
You can send completed your application and first payment 
(made out to Carrier)  to:


  Walter Jarvis Insurance Services
  PO Box 32268
  Los Angeles, Ca 90032
    There is NO FEE for our services
    Nationwide Toll Free:
Tel:      866/344.8061
     Fax:     866/394.8320

       We concentrate on Health Insurance provides rates, applications, and information to better help Arizonans understand their options.  Walter Jarvis Insurance Services, the registered owner of the web site, does not recommend, endorse or provide advice on which insurer to select or which products to buy.
Do not cancel any existing health insurance until you receive written confirmation from the insurance company to which you are applying

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