Home | PRAM Partner Portal

Agent Kenneth Sigler

ken.sigler@kensinsuranceagency.net

Cell 662-806-8533

Select Enrollment option

Select Product

Member Applicant Details

Address and Payment

Overview and Submit

Step 1

Select enrollment option

RxBOOST SPECIALTY
+ FREE Rx Discount card

PRAM’s valuable high-cost medication patient advocacy program. Members will receive assistance in obtaining medications costing $400 and up. Click on 'Learn More' or download brochure for more information about how the program works.

BENEFITS

FORMULARY

BROCHURE

DEDUCTIBLE

BENEFIT LIMIT

MONTHLY RATES

PRIMARY

PRIMARY + SPOUSE

PRIMARY + CHILD(REN)

FAMILY

BENEFITS

FORMULARY

BROCHURE

DEDUCTIBLE

Per Member/Year

RETAIL CO-PAY

MAIL ORDER CO-PAY

BENEFIT LIMIT

Per Member/Month

MONTHLY RATES

PRIMARY

PRIMARY + SPOUSE

PRIMARY + CHILD(REN)

FAMILY

RxBOOST

RxBoost Formulary

RxBoost Brochure

PRAM Rx Discount Card

NO DEDUCTIBLE

NO LIMITS

$30.00

$57.00

$53.00

$69.00

Learn More

Step 2

Select product:

Save your members money on speciality prescriptions by getting pram's speciality product!

Selected State:

Click Here to select a state

FG = Formulary Generic
FB = Formulary Brand
NF = Non-Formulary

* Whichever is greater

Step 3

Enter Member Applicant Details and Dependents

PRIMARY MEMBER APPLICANT DETAILS

Applicant First Name *

15 characters max

Applicant Middle Name

15 characters max

Applicant Last Name *

25 characters max

SOCIAL SECURITY # (Optional)

This is not required. If left blank, we will populate with an alternative ID for our records.

Date of Birth *

Gender *

E-mail Address *

Main Phone *

Cell Phone

Step 4

Enter Address & Payment Method, select Efective Date

ADDRESS

ADDRESS 1 *

ADDRESS 2

City *

State *

Zipcode *

PAYMENT INFORMATION

No payment method is available.

EFFECTIVE DATE

Step 5

Overview enrollment Details and Submit

DOES EVERYTHING LOOK GOOD?

SELECTED PRODUCT

EFFECTIVE DATE

MEMBER(S)

ADDRESS

PAYMENT INFORMATION

Add New Member

Pharmacy Benefits Plan Enrollment

Thank you!

REMOVE