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How To Complete

Enrollment Form Process

College Students

There are 4 ways to Enroll/Apply for
Five Points Health Benefits Student Coverage

 

  • 1 - Apply online. Visit this page and select your state to get started.
     

  • 2 - Apply by phone. Call 915.803.4198 to apply for a health benefit plan and enroll over the phone. 
     

  • 3 - Apply in person. Visit a trained counselor in your community to get information, apply, and enroll in person.
     

  • 4 - Apply by mail, email or fax. Complete your PDF printable application and mail it in, email it or fax it.

1 ONLINE STUDENT APPLICATION
  • Electronically fill out the application and then complete ALL enrollment information and plan options which apply.

  • Please complete LEGIBLY, in its entirety, each section of the document​, signed and dated

2, 3 & 4 - PRINTABLE PDF STUDENT APPLICATION
STEP 2
  • To apply over the phone please call 915-803-4198 to apply for a health benefit plan and enroll over the phone. We have bilingual representatives waiting for your call to complete your application.

STEP 3 - PRINT PDF STUDENT APPLICATION AND SUBMIT IN PERSON AT OUR OFFICE 

 

Attention Student Enrollment Services

Five Points Health Benefit Plans, LLC

6006 North Mesa Street - Suite 108

El Paso, Texas 79912

STEP 4 - PRINT PDF STUDENT APPLICATION AND FAX, EMAIL OR MAIL

​                                         1. Print and send fax to (915) 519-0261 [SECURE LINE]

                                         2. Upload file and email to: 5pteam@fivepointsmecplan.com

*Please be advised to keep a copy of these documents for your own records*
Once your application is completed and received, we will then mail out to you your welcome packet which will include the following:

Once enrolled and your payment is processed, you will receive your Enrollment Packet in the US mail within 5 Business days: 

1) Welcome Packet which includes your welcome letter with your Summary of Benefits (SOB)

2) Your ID member card from the First Health Network is a Aetna | Coventry Company   

 

  • First Health Network is a Aetna | Coventry Company, You will need to take your ID Network Card to your doctor appointments as proof of coverage.

3) Optum Rx ID Card

  • You will need your Optum Rx ID Card when you pick up your prescriptions from any of the major pharmacies.

Customer Service Center hours: M-F 7am - 5pm

Telephone Number: 915.803.4198

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Example

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Example