700 Anthem EPO Plan — Enrollment Application
Complete in one sitting. You’ll receive an email link to review and sign your finished application.
Step 1 of 7PlanApplicantEmploymentFamilyHealthPaymentReview & Submit
Your selectionPick your coverage tier below to see your monthly price and effective date.
Rates effective through 06/30/2027. A $95.00 Annual Administration Fee applies at enrollment (the AFI kit prints $125.00; Fage charges $95.00).
Enroll by end of month for a 1st-of-next-month start.
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