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Colina Documents (English)

UIB Colina Application

Size: 164.7 kBCategory: Colina FormsLanguage: English

International MedAccess Plan Application. The Insurer retains the right to contact the applicant if any question is not explained in detail or if additional information is required.

Payment Authorization Form

Size: 244.3 kBCategory: Colina FormsLanguage: English

Heart Disease and Hypertension Questionnaire

Size: 43.2 kBCategory: Colina FormsLanguage: English

To be completed by the attending physician (PLEASE USE BLOCK LETTERS)

Colina Claim Form

Size: 26.7 kBCategory: Colina FormsLanguage: English

Silver Plan Rate (Area I)

Size: 65.9 kBCategory: Colina RatesLanguage: English

AREA I: Argentina, Belize, Bolivia, Colombia, Guatemala, Nicaragua, Paraguay, Peru, Philippines, Taiwan, Uruguay, Venezuela

Silver Plan Rate (Area II)

Size: 66.2 kBCategory: Colina RatesLanguage: English

AREA II: Brazil, British Virgin Islands, Chile, Costa Rica, Dominican Republic, Ecuador, El Salvador, Honduras, Panama

Silver Plan Rate (Area III)

Size: 65.6 kBCategory: Colina RatesLanguage: English

AREA III: Barbados, Haiti, Jamaica, Mexico, Trinidad & Tobago

Gold Plan Rate (Area I)

Size: 67 kBCategory: Colina RatesLanguage: English

AREA I: Argentina, Belize, Bolivia, Colombia, Guatemala, Nicaragua, Paraguay, Peru, Philippines, Taiwan, Uruguay, Venezuela

Gold Plan Rate (Area II)

Size: 66.8 kBCategory: Colina RatesLanguage: English

AREA II: Brazil, British Virgin Islands, Chile, Costa Rica, Dominican Republic, Ecuador, El Salvador, Honduras, Panama

Gold Plan Rate (Area III)

Size: 66.2 kBCategory: Colina RatesLanguage: English

AREA III: Barbados, Haiti, Jamaica, Mexico, Trinidad & Tobago

Platinum Plan Rate (Area I)

Size: 69.4 kBCategory: Colina RatesLanguage: English

AREA I: Argentina, Belize, Bolivia, Colombia, Guatemala, Nicaragua, Paraguay, Peru, Philippines, Taiwan, Uruguay, Venezuela

Platinum Plan Rate (Area II)

Size: 69.5 kBCategory: Colina RatesLanguage: English

AREA II: Brazil, British Virgin Islands, Chile, Costa Rica, Dominican Republic, Ecuador, El Salvador, Honduras, Panama

Platinum Plan Rate (Area III)

Size: 65.1 kBCategory: Colina RatesLanguage: English

AREA III: Barbados, Haiti, Jamaica, Mexico, Trinidad & Tobago

Agent Personal Data

Size: 121.4 kBCategory: Agent FormsLanguage: English

International Agent/Agency data

Brochure Colina Plan Comparison (EN)

Size: 2.3 MBCategory: Colina PlansLanguage: English

 

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