Thank you for your interest in completing a Health Net individual enrollment application. 
It's simple...just follow these easy steps:
1. 

Download the application using the following steps:

In order to avoid conflicts between the different brands and versions of word processors, our application file is in  Adobe Acrobat v4.0 format. This program will allow you to view and print the application and is available free of charge from the Adobe website.  If you are not sure you have the Adobe Acrobat Reader or may have an older version, click on the "Get Acrobat Reader" button below and follow their instructions to download the program.  For technical support for this program, contact  Adobe.

Click on the application name below that you wish to use.  Depending on your computer's configuration one of two things will occur:
  • The Adobe Acrobat Reader will run and the application will be loaded into it.  You will be able to view the application but not make any edits to it at this time.  Print the application by selecting File from the Adobe Acrobat Reader and then select Print.
  • You may be prompted for a location to save the file.  Typically, downloaded files of this nature are best located in your My Documents folder but if you choose another destination, remember it because you will need to load that application  from that folder after you run the Adobe Acrobat Reader.  You will be able to view the application but do any editing.  Print the application by selecting File from the Adobe Acrobat Reader and then select Print.

Available documents for download (If you haven't downloaded it already):

Individual Enrollment Application (HealthNet.pdf)

(HealthNet.pdf is actual name of document)
2. Complete the application you've just downloaded:
E-Mail

Be sure to follow the instructions on the application carefully.  We have tried to make the instructions easy to follow, but if you have any questions or aren't sure how to proceed, contact me at:

Joseph Morris
Health Plans
Voice: 949-364-6548
Fax: 949-364-6549
Via e-mail: Click on button to the left.
3. Select the billing plan you want.

Monthly (by checking account deduction), bi-monthly (every two months) or quarterly (every three months).
4. Send the completed application along with your check made out to Health Net to:

Joseph Morris
Health Plans
28202 Cabot Rd #500
Laguna Niguel, CA 92677
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