Get Your Assessment

This intake form should take about 5 minutes to complete. PLEASE NOTE: You are never required to release any health related information unless it's required for your enrollment. However, the more you share, the more customized we can make your coverage so please share according to your own comfort level.

INDIVIDUALS &

FAMILIES

Single people or married couples with or without kids, go here.

MEDICARE

MEMBERS

If you currently qualify for Medicare or you will within 6 months, go here.

SELF

EMPLOYED

If it's just you or you and one immediate family member, go here.

SMALL

BUSINESS

If you have at least one additional unrelated staff member go here.

HOW WE SERVE

Your Free 10-Point Quality Assessment Includes...

  • Complete Full Health Assessment For Each Household Member

  • Scan & Cross Check up to 200+ Carriers

  • Cross-Check Providers & Specialists

  • Price Check Medications & Preferred Pharmacies

  • Complete Calculations - MOOP vs. Monthly Premiums

  • Complete Total Protection Proposal With Recommended Plans/Riders

  • Present Top Three Plan Recommendations Based on Assessment Score

  • Marketplace Account Set-Up & Plan Enrollment (if applicable)

  • Complete Your Subsidy Application & Eligibility Determination (if applicable)

  • Ongoing Client Account Support & Maintenance