Blue Cross Blue Shield of Utah Apply

Please note that all applications will be submitted in the name of Wiley Long, the president of HSA for America.  If you have already been working directly with one of our advisors, then that person will be noted in our system as your personal contact.

Before applying for the Regence HSA Healthplan, review the Benefit Summary for the plan you are interested:

Benefit Summary: $1,500 Single/$3,000 Family Deductible Benefit Summary: $2,500 Single/$5,000 Family Deductible Benefit Summary: $3,500 Single/$7,000 Family Deductible

To apply by fax or mail, just follow the instructions below:

1. Open the Blue Cross Blue Shield of Utah application
   
   When the Adobe Acrobat reader opens with the application, use the menu bar at the top to save the application to a file or simply print it out right from the reader.  (You may also fill out our Application Request Form and we will send you an application right away.)
   
   
2. Simply follow the instructions on the application.  Fax the completed application to us toll free at 1-866-284-0082, or mail it to us at the address below.

Please fill out the application Completely.  Any unanswered questions will delay the processing.  If you have any questions about filling out the application, email us at info@HSAforAmerica.com, leave your name and phone number, and someone from our office will call you back and answer any application questions you have.

Note:  All policies come with a money-back guarantee.  After receiving your policy, you have 10 days to review it.  If for any reason you decide not to keep the policy, you will receive a full refund of your initial premium.  Remember that you also have access to the guaranteed lowest life insurance rates available, with easy online quotes and applications.