I'm a Broker

Welcome! We are glad that you are interested in our Medicare Supplement Products. See below for additional plan forms, brochures and informaton on how to get contracted.

• Application for a Medicare Supplement Policy (PDF)
• 2024 Outline of Coverage (PDF)
• Automatic Bank Draft Form (PDF)
• Disenrollment Form (PDF)
• Health Net Medigap Plans Pre-Enrollment Guide (PDF)
• Choosing a Medigap Policy (PDF)
• 2024 Medicare Supplement Guaranteed Issue Guide (PDF)
• Medicare Supplement Replacement of Coverage (PDF)
• Optional Standard PPO Dental Brochure (PDF)
• Optional Standard PPO Dental Plan Application (PDF)
• Healthy Discount Brooklet (PDF)
• Acupuncture and Chiropractic Care (PDF)
• 2025 Acupuncture and Chiropractic Care (PDF)
• 2025 Med Supp Enrollment Form (PDF)
• 2025 Med Supp Outline Coverage (PDF)
• 2025 Guaranteed Issue Guide (PDF)
• 2025 Health Discounts Booklet (PDF)
• 2025 Med Supp Opt Standard PPO Dental Appplication (PDF)
• 2025 Replacement Coverage Form (PDF)
• 2025 SIlver & Fit Healthy Aging Exercise Program (PDF)

Broker Reference Materials

• How to read your Commission Statement - English (PDF)
• Commission Rates (PDF)

Note: If you are interested in also selling Medicare Advantage Products, visit our Medicare Advantage website.

After you receive the ready to sell notification email from Health Net, you are now able to create an account through our Broker Portal to view your book of business and commissions statements.