New West Agents

AGENT RESOURCE CENTER

Need Assistance?

Quote Information
1-888-500-3355

Marketing Underwriting Fax
406-457-2297

The following information is provided for appointed New West Agents.

2007 Products

Quoting Materials

Enrollment/Change Form

Miscellaneous Forms

Member Authorization Form

Member CLAIM Forms

Claim forms are used to submit claims directly to New West PO Box 548 Kalispell, MT 59903-0548

Caremark Pharmacy (optional benefit)

COBRA (optional benefit)

COBRA Qualifying Event Form
This form is used by groups who have COBRA administered through New West.

EFT (Electronic Funds Transfer)

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