Share information with us

 
Plans Plus Benefits is eager to work with you but we'll need a bit more information to get started. Below you will find surveys to collect information on the doctors and specialists you're currently using, as well as a form that will designate our company your Broker of Record for health insurance in New York State. If you have any questions at all, please don't hesitate to contact us.
 
 

Provider Survey

Click to download Provider-Survey.pdf

Group health insurance doctor survey: Help us determine whether sufficient numbers of providers are available within the network of a new plan you're investigating. Ask your employees to fill out this survey of the physicians currently being used by your employees and their families.

 
 

Individual Survey

Click to download Individual-Survey-2.pdf

Individual health insurance doctor survey: Fill out this survey to help us investigate an individual health insurance plan for you. Share your contact information, your household's estimated gross income, and the names and contact information for your doctors

 
 

Broker Of Record Agreement

Click to download NYSOH-Individual-BOR.pdf

Fill out this form to designate Plans Plus LTD as your Broker of Record for health and dental insurance plans in New York's individual marketplace.