County Health Dept. ListView a list of all the County Health Dept contact phone numbers for Program Eligibility.Program Ins. Enrollment: 1-844-441-4422Call for help with enrollment in Insurance for the Program.Eligibility: 1-844-381-2327Call for help with Program Eligibility.
** Important Changes for 2024 ** Before completing the form, please READ before enrolling.
I already have an Insurance Policy

Participant has a health insurance policy through one of the following:

Marketplace / ACA
Employer-Sponsored
  1. Please be sure to download the third-party letter template and have it completed by your employer prior to enrolling.
    You will need to attach this document on the enrollment form. Download third-party letter template.
  2. Have your benefit packet available for upload to check on premium affordability.
COBRA
  1. Please be sure to have your entire COBRA package ready.
    You will need to attach these documents on the enrollment form.
  2. Make sure the package includes a signed and dated election form.
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