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Home

About
MBN-USA

Medicare

Group
Insurance

Individual Insurance

Workplace
Rewards

Forms

Contact

Get a Quote TODAY and Start SAVING!

  • CALL: 412.341.1400
  • TEXT: 412.927.2792

IMPORTANT FORMS FOR YOUR EASY ACCESS

United Health Care Forms:

  • Level Funded Billing and Collection Agreement
  • Plan Sponsor Application
  • Level Funded Application for Excess Loss Insurance
  • New York Electronic Filing User ID Application
  • New York Payor Election Application
  • State of New York Health Care Reform Act - Public Goods Pool
  • Demographic Spreadsheet

110 Roessler Rd, Suite 100

Pittsburgh, PA 15220

Phone Number:

412.341.1400

Office Hours:

9AM - 4PM, Monday - Friday

506 Washington Rd

Washington, PA 15301

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