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Broker Forms

Below are forms that you may need from Health Plus.
The documents on this page are available in Adobe Acrobat Format. Click on the icon to download forms.

Provider Directory
 Annual Notice
 Notice of Privacy Practices
 Prescription Drug Reimbursement Form
 Privacy Notice
 Health Plus of Louisiana Member Formulary Guide
 Employer Application
 Small Group Member Application (MED)
 Large Group Member Application (NON-MED)
 Broker Checklist
 Service Area Participating Pharmacies

Meet Our:
 Urologists
 Gastroenterologists

The documents on this page are available in Adobe Acrobat format. Adobe Acrobat can be downloaded here.

Health Plus is a wholly owned subsidiary of Willis-Knighton Health System
Created for Health Plus by Praeses