Information You Need to Apply for Coverage

Individual & family health insurance policies

Before you attempt to fill out an application you need to make sure that you have the following information available:

• Date of birth of all the applicants
• Social Security number of all applicants
• Information about the last doctor’s visits of all applicants
• Name and address of family doctor for all applicants if anyone has a family doctor
• Credit card or checking account number from which your premium will be paid

Group Health Insurance Policies

For group coverage you need to have all the above information plus you need to show:

• A copy of your last payroll showing employees to be covered
• DE-6 form, showing the name of employees to be covered
• Name of all the officers and owners to be covered