Download and Print The Application Now

Blossom 4 Health Plans

"As featured on Public Access Television"

Toll Free 800-237-0391

FAX 818-368-0215

Serving California for over 22 Years

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Download The Vision Plan Enrollment Application

Enrolling With Any of the above Is Simple. Just Follow These 3 Easy Steps...

Step 1

Complete the application available from this web site. Be sure you follow the instructions on the application carefully. We have tried to make the instructions easy to follow, but if you do have any questions or aren't sure how to answer a question, contact our customer service department at: 1-800-767-4077

Step 2

SELECT THE TYPE OF BILLING YOU WANT -- Monthly (by checking account deduction), bi-monthly (every two months) or quarterly (every three months). Note: Payment plans may be limited by the carrier.

Step 3

SEND THE COMPLETED APPLICATION ALONG WITH YOUR CHECK TO:

Blossom 4 Health Plans, Inc
16479 Halsey Street Suite 1000
Granada Hills, CA 91344-2942

MAKE YOUR CHECK PAYABLE TO: - Vision Plan of America