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Forms and Resources

​Easy Resource Page

PSHP plans are unique and comprehensive, and are geared toward groups with members over age 65 enrolled in Medicare Parts A and B.

​What is PSHP?

​For your convenience, we encourage you to use this "easy resource" page for benefit grids, plan designs, and enrollment forms. Simply click on the appropriate pdf link. Should you need more information, please call: (855) 344-7747.

Getting Started

PSHP One-Page Overview
File Size: 174 kb
File Type: pdf
Download File
PSHP Broker FAQ
File Size: 175 kb
File Type: pdf
Download File
PSHP Presentation for Clients & Prospects
File Size: 1308 kb
File Type: pdf
Download File
Services Provided to Contracted Brokers
File Size: 142 kb
File Type: pdf
Download File
Group Medicare Quote Request Form
File Size: 12 kb
File Type: xlsx
Download File

Benefit Grids & Rates

2021 Benefit Grids & Rates
File Size: 2338 kb
File Type: pdf
Download File

2021 Enrollment Forms

PSHP New Group Enrollment Kit – Medical & Rx
File Size: 1302 kb
File Type: pdf
Download File
PSHP New Group Enrollment Kit – Medical Only
File Size: 629 kb
File Type: pdf
Download File
PSHP New Group Enrollment Kit – Rx Only
File Size: 996 kb
File Type: pdf
Download File
PSHP Rx-Only Enrollment Kit for Current Medical-Only Sponsors
File Size: 892 kb
File Type: pdf
Download File
PSHP Individual Member Enrollment Form (Medical and-or Rx)
File Size: 70 kb
File Type: pdf
Download File
(888) 344-2522​
5640 W Maple Road
Suite 304
West Bloomfield, MI 48322​
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