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Avera Health Plans Producer Supplies Request Form

To request additional supplies from Avera Health Plans, please use the form below or contact our Marketing Department Monday-Friday, 8 a.m. - 5 p.m. CT at (605) 322-4500 or toll-free at 1 (888) 322-2115.

  * Required Fields
Date Requested:
* Producer Name:
Agency Name:
* Address Line 1:
Address Line 2:
* City:
* State:
* Zip:
Attention:
* Phone:
Items and Quantities Requested:
 
 QuantityItem
Avera Health Plans Group Insurance Brochure
Avera MyPlan Individual Insurance Brochure
Care Partners Brochure
Flexible Spending Program Brochure
My 365 Brochure
Value-Added Services Brochure
Other