Let’s Win Some Small Group Business!

Thank you for your interest in partnering with Arise Health Plan to reach small group leaders in your area!

Before filling out the form on this page and subsequent pages, please be sure you’ve reviewed the co-op brochure provided to you and have selected one of the three co-op participation tiers. If you have questions or need clarification on these plans, please talk with your Arise Health Plan Agent Relations representative before proceeding.

After you’ve completed these forms and been accepted into the program, the Arise Health Plan marketing team will get to work on planning our co-branded campaign.

To view a sampling of the marketing materials that may be included in your campaign, click the button below. This will open a new tab in your web browser. Then, come back to this tab and start by filling out the basic contact information to the right.

STEP ONE: Agency Information

All fields required unless otherwise noted.