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Menu
About
About HMA Advanta
Careers
Contact Us
Members
Log Into Portal
Nominate Provider
Forms & Resources
Request ID Card
Employers
Solutions
Log Into Portal
Advisors
Solutions
Sales & Quotes
Providers
Log Into Portal
Access Forms
No Surprises Act
Replacement ID Card
Please complete the form below and we will send you a replacement card right away. Generally, a replacement card will be mailed within 5 business days.
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Name
*
Member ID # or Subscriber ID #
Employer Name
*
Phone Number
*
E-mail Address
*
Mail Card To
Reason for Requesting New Card
*
Submit Request
