Enrollment
Have access to the tools you need to enroll your clients in one of your UPMC for Life plans, including how the enrollment process works.
Enrollment application process
Learn how the enrollment application process works and all the ways that your clients can easily enroll and make sure to complete the pre-enrollment checklist.
2026 Enrollment applications
- Allegheny, Erie, and NWPA
- Berks County
- Carbon County/South Central/North Central
- Cumberland/Dauphin/Lancaster/Lycoming
- HMO/PPO plans – Central PA
- HMO/PPO plans – Western PA
- Johnstown/Altoona
- Northeastern PA
- Ohio
- PPO Salute
- PPO Salute – Southeastern PA
- Southwestern PA
- UPMC for Life Complete Care (HMO SNP) application
- Westmoreland County
- York County
2026 Enrollment kits
- Allegheny MA PA Kit
- Southwestern PA MA Kit
- Northwestern PA MA Kit
- Erie MA Kit
- Johnstown/Altoona MA PA Kit
- Central PA Premier MA Kit
- Central PA MA Kit
- Westmoreland MA Kit
- Northeastern PA MA Kit
- Berks MA Kit
- Carbon MA Kit
- York MA Kit
- Veterans MA Kit
- Veterans Southeastern PA MA Kit
- OH MA Kit – Harrison and Jefferson counties
- HMO Ded Rx HMO Rx Enh PPO High Ded Rx PPO Rx Enh WPA MA Kit
- HMO Ded Rx HMO Rx Enh PPO Rx Enh Central PA MA Kit
- UPMC for Life Complete Care SNP Kit – Northeastern PA
- UPMC for Life Complete Care SNP Kit – Southeastern PA
- UPMC for Life Complete Care SNP Kit – Western and Central PA
Agent of record (AOR) change form
Your client must fill out the form linked below to transfer agent of record.