Paper application for Celtic HSA

TA | August 13, 2008

Q: I started to complete the online application form but apparently did not have all the info to complete it. Is there a form I could use instead? I am looking to setup a HSA with a high deductible of $5000 insurance plan. Please advise if there is a plan for which we would qualify and the cost?

A: Yes, applications for the CeltiSaver Health Savings Account plan are available in PDF format for download at http://www.CelticEnrollment.com. See the Site Map to find the correct application for your state of residence.

The applications can be mailed or faxed as indicated in the form, but we strongly suggest that you gather the information necessary on the paper form and then go back online to submit the application electronically. Online applications are more secure, are faster to complete, have a lower error rate, are processed more quickly and a greater overall chance of being approved than paper applications.

Premium rates are not available in paper form and must be generated using the online quote system. If you were already trying to complete the application online, this indicates that you already received a rate and selected the desired health plan options.

A list of participating PPO Doctors can be accessed from the same Web site or PHCS.com, or you can simply ask your doctors if they are "PHCS" (Private Healthcare Systems) participating doctors. This is the largest and most highly regarded independent PPO network in the U.S. so there is a good chance that your doctors are participants.

When you submit an application, the underwriter reviews the medical history you entered for eligibility and qualification for the standard rates. In some cases the underwriter will request additional information, so it helps to have a copy of your medical records just in case this is requested. If there is any problem you will be notified and offered the opportunity to withdraw your application. Celtic Insurance does not deny insurance applications.

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