Producer

Forms and Applications

Enrolling a group has never been easier. By accessing the TDA sales tools, you will have everything you need to enroll your new group today!
Please download the form appropriate to your need. The downloads are in Adobe PDF format (.pdf) and can be filled out and submitted back to any TDA representative.

Group Applications
Click on the links below to download the appropriate form.

TDA Arizona Products
TDA Utah Products
Group Application Plan Booklet
Companion PPO Plans  
Town and Country PPO Plans  
DHMO Plans