Group Health Cooperative - Cooperative Advantage

Contact Me

I would like to speak with a Cooperative Advantage representative to discuss the Cooperative Advantage (HMO D-SNP) plan that includes a prescription drug benefit.

Full Name:

Beneficiary or Authorized Representative (if applicable) :

Phone Number:

Email:

Best Time to Call:

Signature:

Checking this box provides your electronic signature

Today's Date:

I agree. Please ask a Cooperative Advantage representative to contact me.

Enter security code:

CMS ID Number: H7598_CAGHC20063_M | Last Updated On: 10/14/2022 10:22:55 AM