How to Apply Online

You can apply and purchase a plan online by following the links below.

  1. Health and Dental Plan
  2. Guaranteed Acceptance Plan
  3. Group Conversion Plan
  4. Retirement Plan
  5. Stand-Alone Dental Plan

How to Apply via Mail

1. Download the insurance application form you need

Blue Choice Plan Insurance Application (PDF) (medically underwritten)

Guaranteed Acceptance Health Plan Application (PDF) (non-medically underwritten)

Group Conversion Insurance Plan Application (PDF)

Retirement Health Plan Application  (PDF)

2. Print and complete the form or fill it out electronically (they are editable PDFs)

3. Attach a void check or fill out credit card information (or copy of a void check, credit card or banking information)

4. Send us the forms (contact your advisor for address)

Need a Hand?

One of our advisors would be happy to help you complete the application process over the phone. Call us: 1-844-361-5244

Apply for Travel Insurance

Contact one of our travel insurance specialists to obtain a quote and coverage: 1-844-361-5244

MacLellan Moffatt Health Insurance prides itself on their level of service. Don’t hesitate to contact us directly to assist in the application process or to get more information on Pacific Blue Cross or other products.