COLLEGE STUDENT PLANS - STUDENT SELECT MEDICAL

SPECIAL NOTICE: To save your valuable time, please read these instructions before proceeding.

There are now TWO options for applying for short term medical. Either option can be accomplished online.

1. Apply online with a credit card.

OR

2. Print and mail form with payment.

TO APPLY ONLINE:

Click here to visit the John Alden Short Term Medical website. When prompted, enter my agent code number:

MY AGENT CODE NUMBER: M8951

TO APPLY BY MAIL:

Click here to visit the John Alden Short Term Medical website. When prompted, enter my agent code number, printed in the box above. Choose the pay-by-check option. This will generate a form for you to print and sign. For your convenience, the form will contain your information and the premium based upon the data provided by you.

EFFECTIVE DATE:

Coverage is effective no sooner than midnight the date of the post mark by the US Postal Service. You may choose the effective date by filling it in on the application. It can be no earlier than the day following the canceled post mark.

PREMIUMS: 

• May be paid in full or on a monthly basis. 

• May be paid by check or credit card.  If paying by credit card, be sure to sign the card authorization box.

QUESTIONS?

Please send me a NOTE if you have any questions about health plans for your business. Any specific questions about Short Term or Student Select Plans should be directed to the insurance provider. I will assist you if you cannot get an answer to your questions. 

NOTICE: Every effort is made to keep these applications up to date. Revisions are posted as soon as we receive proper notification. For the latest information the insurance company web sites should be consulted. We are not responsible for changes implemented by the insurance companies or fluctuations in their rates.

Thank you for visiting my web site

Randy Cryer, Consultant
206-510-8621