Avera Health Plans Forms & Brochures

Below is a list of forms and brochures that you may find useful. If you don’t see the information that you are looking for, please contact the Avera Health Plan Service Center Monday-Friday, 8 a.m. - 5 p.m. CT at (605) 322-4545 or toll-free at 1 (888) 322-2115.

• Authorization Representative Appointment
• Avera Health Plans Benefit Administrators Flyer (self-funded)
• Avera HSA
• CarePartners Brochure
• Change Form& Change Form Overview
• COBRA Notice of Qualifying Event Form & Instructions
• Employer Application/Subscription Agreement
• Employee Assistance Program (EAP) Flyer
• Flexible Spending Account Brochure and Forms
• Marketing Brochure
• Out of Area Dependent Registration Form
• Request for Group Quote
• Student Verification Form