Before complete this form, please note that it is for feedback, only, and not customer service. If you are a Health Connector member and experiencing an issue with your account that could not be resolved through calling customer service, please use the Ombuds Contact form.

If you have general feedback about the website or call center experience, or wish to report a technical issue. You may use the form below. Please do not include any personal information such as Social Security numbers, date of birth, addresses, bank account numbers, or personal health information.

  • Please fill out the information below:
  • Write your feedback in the box provided below. Remember, DO NOT include any additional personal information such as Social Security numbers, date of birth, addresses, or bank account numbers.