Do not complete this form if you have already completed an enrollment in a Marketplace / ACA Health Insurance Plan for 2025 through either:
Only complete this form if you need assistance with Marketplace / ACA enrollment from BRHPC/American Exchange. American Exchange is a CMS Certified Federally Facilitated Marketplace Agent/Broker in the State of Florida and will act as your Agent of Record upon completing this form.
Before continuing, please ensure you have the required information to enroll:
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