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Important Evergreen Health Plan Changes Effective January 1, 2009

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Agents & Broker Section Employers Section Members Section Providers Section My Humana
 

Friday, July 30, 2010

 
    Request New ID  
 
 

Request ID Card Page

By completing this form you will be sending a request to Evergreen Health Plan to mail a new card to your address already on file. If you enter a different address in the form below, an Evergreen Representative will call to verify your address before sending the new card(s).

First Name   Last Name
Address
City   State  Zip
Daytime Phone Number
Employer
Member Number
Please enter of the names of any of your dependents that also require a new insurance card.
Spouse Child
Child Child
Child Child

Please allow 7 to 10 business days for your new insurance card(s) to arrive.

 

 
 

 
       
707 Center Street Suite 110, Columbus, GA 31902-0790
(706) 660-6175 ▪ Fax (706) 660-6515
Members Services (888) 294-9451 ▪ (706) 660-6550 ▪ Fax (706) 660-6275
Email: Evergreen.Suggestions@crhs.net
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