Before you start your application, it will help you to have the information listed below ready to look at as you fill out your application. Also, you may be asked to send us copies of some of these documents or others if we need more proof from you after we get your application.
Basic information you will need
Extra information you may need if you have a job that offers health insurance
If you do and your job offers health insurance, ask your employer these questions or download and have them complete the Employer Coverage Form (PDF):
- Do any of the health plans that the employer offers meet the “minimum value” standard?
- What is the employee contribution to the lowest-cost health plan offered by your employer for an individual plan?
- How often?
- Weekly
- Every 2 weeks
- Twice a month
- Monthly
- How often?
Other information that may be helpful to have
- If you are found eligible for coverage through the Health Connector and you plan to make a payment online, you will need your bank routing number and account number for either your checking or savings account (if you have a premium).
- If you are found eligible for coverage through the Health Connector and you plan to make a payment by mail or in-person, you will need a personal check or money order to make a payment for your first month’s premium (if you have one).