PHCS Ultra 8000 HSA — Enrollment Application
Complete your application below. You’ll then get an email to review everything and sign.
Step 1 of 6CoverageApplicantHouseholdHealthPaymentReview
Your selectionMember Only · $719.00/mo · effective 12/01/2026
Choose your coverage
Monthly premium$719.00
Admin fee$10.00/mo
Recurring monthly draft$729.00
First month (incl. one-time $125.00 processing fee)$854.00
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