Items to have ready for your enrollment application either in-person or over the phone:


  • First, click here for understanding requirements for an in-person meeting during the Covid-19 pandemic.

  • For Affordable Care Act (aka Obamacare) applications with a tax-credit (help for paying for coverage), whether or not they are applying for coverage, we will need this information on all household members including spouse, and other dependents (if not applying for a tax-credit then information for only those individuals needing coverage will be required):

    • For everyone:

        • Formal full names​ as listed with Social Security

        • Dates of Birth

        • Smoker Status

        • Residential Addresses

        • Social Security #s and/or Social Security Card(s)

        • Current Insurance Cards (if any)​​, including any ancillary coverage such as Dental, Vision, etc.

        • List of your preferred Providers (doctors, dentists, hospitals, clinics, etc)

        • Optional but Recommended: Medication List including dosages, quantity prescribed and type of medicine (pill, tablet, vial, inhaler, etc).  Not all medications are covered under all plans.  However, with your list coverages can be verified prior to selecting a suitable plan.

        • If you are applying for an ACA plan (aka Obamacare), mid-year (not during Open Enrollment), please have available documentation proving your Qualifying Life Event. This documentation may be emailed (using a scanner or camera if not already in email form), or faxed to me for submission, or submitted via U.S. Mail.  This is not required for non-ACA plans.

          • Examples Include (not all may be necessary, check with Ken first):​

            • Letter from Employer showing termination date and last date of employer-sponsored health insurance and those in your family who are losing insurance​

            • Marriage Certificate

            • Proof of new address (utility bill)

            • Proof of Citizenship

            • Birth Certificate of newborn

            • Adoption or Custody Placement documents

            • Termination letter from BadgerCare

        • If you are applying for an APTC (Advanced Premium Tax Credit) with an ACA plan (otherwise known as a subsidy), have available with you some or all of the following documents or information:​

          • Gross Household Earnings (based on your tax household)​ for all sources of income.  Prior year tax return showing Adjusted Gross Income is sufficient so long as there are no major changes since the return was filed.

          • Two most recent income paycheck stubs

          • If Self-Employed, a ledger estimating annual income/expenses

          • Social Security statements

          • Investment Earnings (taxable)

          • Taxable Retirement Distributions

          • Traditional IRA and 401K retirement contribution amounts

        • If you are a permanent resident or not a U.S. citizen, please have available appropriate documentation supporting your legal residency.​

      • For Medicare-Eligible applicants, in addition to above, also:

        • Have your current Medicare Card​​ ready and with you.

      • LAST BUT NOT LEAST, please bring or have ready a method of payment to make your Initial Premium Payment (also known as your Binder Payment).  Most companies accept Automatic Draft our of a Checking or Savings Accounts.  Some companies accept MasterCard, Visa and Discover.  It is best to bring both if possible since each insurance company is different.    |    (262) 536-5155

211 N. Franklin St., Suite 204

Port Washington, WI   53074

Office Hours By Appointment Only

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