Enrollment Checklist

When you meet with us to enroll in the Affordable Care Act, please have the following information with you.


  Information Example
1 Proof of US Citizenship Social Security Numbers or Immigration status numbers for all family members.
2 Proof of State Residency Driver’s license, housing lease, or utility bill
3 Previous Year Tax Return Copy of your 2012 tax return
4 Income for all family members W-2 forms or pay stubs, unemployment, disability, social security, pension, retirement income, etc
5 Current Health Insurance Policy numbers for any current health insurance and information about available job-related health insurance.
6 Method of payment Checking/savings account details or credit/debit card details.
7 Valid email address Required to enroll online