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.

Effective 3/1/2023 - 2/28/2024 Indvidual Medicare Supplement Pre-Sale

• Application for a Medicare Supplement Policy (PDF)
• 2023 Outline of Coverage (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)
• 2023 Medicare Supplement Guaranteed Issue Guide (PDF)
• 2024 Medicare Supplement Guaranteed Issue Guide (PDF)
• 2023 Combined Acupuncture and Chiropractic Care (PDF)
• Medicare Supplement Replacement of Coverage (PDF)
• 2023 The Silver&Fit^® Healthy Aging and Exercise Program (PDF)
• 2023 Decision Power Healthy Discounts (PDF)
• Optional Standard PPO Dental Brochure (PDF)
• Optional Standard PPO Dental Plan Application (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.