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We will need documentation showing your estimated annual income prior to your appointment. It would also be helpful for you to have an account already set up with the Marketplace. The following information will tell you how to do that:

1. 1. Log onto www.healthcare.gov
2. 2. Click “Log in” in the upper right hand corner
3. 3. Click “Create one” underneath the white “Log in”
4. 4. Follow the rest of the instructions to create your account

***We are legally not able to store this login information, so please keep this information handy as you will need to access your account each year to re-enroll during Open Enrollment, as well as access important tax related forms.

Client Intake Form
Please be sure to provide all of the required information.
DOWNLOAD CLIENT INTAKE FORM

Prescription Analysis Form
If you would like us to do a comprehensive analysis of your out of pocket costs for your medications, along with the drug plans available to you, we are happy to assist with that. To do that, we will need you to include all medications you take along with the daily dosage, how often you fill the Rx and the pharmacy you use. *Be sure to note if you take the Brand name or Generic. If you use an inhaler, please bring the inhaler to your appointment. If you use insulin, please note the vial units/ml and how many you use per month. If you are not comfortable providing us with that information, happily disregard.
DOWNLOAD PRESCRIPTION ANALYSIS FORM

Marketplace Consent Form
Licensed agents play a key role in the Health Insurance Marketplace (Marketplace) by providing consumers with expert guidance on plan options in their local area while assisting with everything from comparing costs and coverage to apply for financial assistance. The purpose of this form is to obtain consent from you, the client, so that our agents can help.
DOWNLOAD CONSENT FORM