Ascension Complete: 2023 Enrollment Application Form Corrections

Ascension Complete has identified some issues with the printed versions of some of the 2023 Enrollment Application documents contained within the 2023 Enrollment Guides. The printed enrollment forms will not be updated and remain available for order. You can continue to use the Enrollment Application Forms found in the Enrollment Resource Guide or download updated forms. The below updated Enrollment Application Form documents should replace    Enrollment Application Forms in the printed guides. 

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Texas

The Ascension Complete Seton Access Plus (PPO) H9357-001 and Ascension Complete Seton Access (PPO) H9357-002 Enrollment Application Forms on Page 2 erroneously list Williamson county twice. The enrollment application within Ascend is unaffected.

• H9357-001 2023 Ascension Complete Seton Access Plus (PPO)
• H9357-002 2023 Ascension Complete Seton Access (PPO)

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Illinois

The Ascension Complete Illinois Secure (HMO) H7399-002 Enrollment Application Form on Page 2 erroneously lists the plan name as Ascension Complete Illinois Reward (HMO) H7399-002. The enrollment application within Ascend is unaffected.

• H7399-002 2023 Ascension Complete Illinois Secure (PPO) - English
• H7399-002 2023 Ascension Complete Illinois Secure (PPO) - Spanish

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Michigan

The Ascension Complete Michigan Access (PPO) H7512-002 and Ascension Complete Michigan Access (PPO) H7512-004 Enrollment Application Forms on Page 2 erroneously list the plan name as Ascension Complete Michigan Access Plus (PPO). The enrollment application within Ascend is unaffected.

• H7512-002 2023 Ascension Complete Michigan Access (PPO)
• H7512-004 2023 Ascension Complete Michigan Access (PPO)