To ensure Eligibility Guidelines, brochures, applications and rates reflect legislative requirements of the CHAND program, they are no longer available in paper form. Please refer to the links below.
If you need additional information regarding CHAND, please contact us.
Please note if you are a Traditional applicant, you must review the Creditable Coverage Disclosure Notice.
Authorized Representative Form
Please complete an Authorized Representative Form and include it with your application.
Authorization to Release Information Form
Authorize release of your information to a person or organization.
Automatic Payment Withdrawal
Authorize your financial institution to deduct CHAND premiums from your account.