Search
Close this search box.

We’re here to help.

Call 1-800-410-7778 (TTY: 711)

MHBP Information request form

Would you like information about MHBP mailed to you?

You can request an official plan brochure and summary benefit information by completing the form below.

Quick Links:

Share this page:

MHBP Information request form

MHBP members: Select “MHBP Member” and complete the form to request health plan information.

Non-members: Check “No” and complete the form to receive benefits information.

* Required information


Have questions? We’re here.

Call 1-800-410-7778 (TTY: 711)
24 hours a day, 7 days a week, except certain holidays