| Short Term Health Insurance - The Secure 12x3 STM |
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To apply by mail or fax,
simply print your application below
If you purchase the Secure STM plan elsewhere, make sure you understand |
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any additional fees that may be added by the insurance agency or broker. |
| You could end up paying $30 to $100 extra for the same plan. |
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| Print NEW Rate Sheet if applying by mail or fax - Click Here |
| To apply by mail or fax, simply click on your state located above. |
| The application will open in a new window to view and print. |
| Need Help? - Call 1-800-544-9505 |
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