HBR Contact Information

The State Health Plan (Plan) communicates with HBRs on a regular basis and it is critical, that the Plan have accurate information for each employing unit.

It is the responsibility of each employing unit to ensure the Plan has correct contact information. 

By including your email address, you agree to be included on the Plan's email list to receive HBR Updates/Alerts. 

Thank you in advance!

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* 1. HBR First and Last Name

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* 2. Title

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* 3. Employing Unit

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* 5. Employing Unit Address

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* 6. HBR Email Address

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* 7. HBR Phone

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* 8. HBR Access Needed

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* 9. Check the boxes below in which you serve as the contact.

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* 10. Are you replacing anyone?

 
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