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)
• Automatic Bank Draft Form (PDF)
• 2026 CA-Automatic Bank Draft (PDF)
• Disenrollment Form (PDF)
• Health Net Medigap Plans Pre-Enrollment Guide (PDF)
• Choosing a Medigap Policy (PDF)
• 2026 Choosing a Medigap Policy (PDF) 
• Optional Standard PPO Dental Brochure (PDF)
• 2026 Optional Standard PPO Dental Brochure (PDF)
• 2025 Acupuncture and Chiropractic Care (PDF)
• 2026 Acupuncture and Chiropractic Care (PDF)
• 2025 Med Supp Enrollment Form (PDF)
• 2025 Med Supp Outline Coverage (PDF)
• 2026 Med Supp Outline Coverage (PDF)
• 2025 Guaranteed Issue Guide (PDF)
• 2026 Guranteed Issue Guide (PDF)
• 2026 CA Med Supp Pre-Guide (PDF)
• 2025 Health Discounts Booklet (PDF)
• 2025 Med Supp Opt Standard PPO Dental Appplication (PDF)
• 2026 OSPD Application form (PDF)
• 2025 Replacement Coverage Form (PDF)
• 2025 SIlver & Fit Healthy Aging Exercise Program (PDF)
• 2026 Silver & Fit 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.