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.
2025 Enrollment applications
- Allegheny County
- 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
- Tioga County
- UPMC for Life Complete Care (HMO SNP) application
- Western PA/Lawrence County
- York County
Virtual enrollment tools
Your clients can enroll in one of our UPMC for Life plans from the safety of their own home.
Agent of record (AOR) change form
Your client must fill out the form linked below to transfer agent of record.