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Annual Meeting Registration

2014 AHI Annual Meeting and Conference Registration

SPECIAL NOTE: Don’t forget to also BOOK YOUR HOTEL at the special GROUP RATE!

Personal Information: Items marked with an asterisk* required

*First Name

*Last Name

Degree(s)

*Name as it should appear on your nametag

Title

*Organization

*Address 1

Address 2

*City

*State

*Zip code

*Telephone number (Best number to reach you for questions.)

*E-mail

Do you have any dietary restrictions? Please describe.

Do you have any physical restrictions/requirements? Please describe.

Attendee Registration Category: Select ONLY one option

 AHI Member Health Plan Representative: Group fee payment (maximum 10 attendees) : Two-day, including September 8 dinner AHI Member Health Plan Representative in addition to the group: Two-day, including Sept. 8 dinner: $125 AHI Member Health Plan Representative in addition to the group: One-day, Sept. 9 only: $100 Individual Non-member: Two-day, including Sept. 8 dinner: $150 Individual Non-member: One-day, September 9 only: $125 Event Speaker: I am an event speaker

Registration for Conference “Special” Events

Please indicate all sessions you plan to attend. (These sessions require specific counts for seating and catering.)

Monday, September 8

3:00 p.m. Meetings
Meetings limited to AHI Standing Committee members and designated invitees (Choose only one)

4:00 p.m.
 AHI Business Meeting (Required by AHI Bylaws) (Event limited to AHI Board of Directors and designees)

5:00 p.m.
 Networking Reception with Exhibitors

6:00 p.m.
 Dinner

Tuesday, September 9

6:00 a.m.
 Wellness Activity

8:00 a.m.
 PAC Breakfast ($25 additional fee) Note: The Breakfast is not included in the registration fee. This is a separate fee for those attending the Breakfast and must be paid with personal dollars. No corporate credit card payments allowed. Payment can be made by personal check and made payable to the “Alliance of Health Insurers PAC”. Payment can be mailed in advance of the Annual meeting to the Alliance of Health Insurers at 44 E. Mifflin, Suite 901, Madison, WI 53703 or can be paid the day of the event.

Noon
 Lunch