In order for us to process your enrollment thru the Health Insurance Marketplace, please sign the authorization form below.
Information Needed for Quote and/or Enrollment
- Immigration documentation (i.e. residence card)
- Social Security numbers & Birth dates for all household members
- To qualify for financial assistance(tax credits) we need income, expenses, and deductions of everyone in your household, even those not applying for coverage.
- Employer and household income information (i.e. tax return)
- Anyone you include on your tax return as a dependent, even if they don’t live with you.
We’re happy to help you compare and enroll on insurance plans that fit your needs. Free HELP via phone, office or home visit appointment.
