Neighborhood Health Plan

Broker Forms and Resources

The forms and resources below will provide you with the broker tools you need to sell NHP’s insurance plans. Please note that additional information/materials are available in the Members section of this website.

Administrative Guide - Important information about enrolling you employees with NHP and accessing plan services.

Service Area Map

• NHP Commercial HMO Service Area

Compare Co-Payments across Business Choice Plans

• Copayment Cross-Reference (Plan Year Deductible Plans)
• Copayment Cross-Reference (Calendar Year Deductible Plans)

Enrollment Resources

• Domestic Partners Position Statement
• Enrollment Form
• Employee Waiver Form
• Employer Group Application Form

Broker Forms

• W-9 Request for Taxpayer ID
• DOI's Broker License