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Capabilities of the Agency Support Role
2024 Individual Creditability Coverage Determinations
2024 Small Group Creditability Coverage Determinations
2024 Large Group Creditability Coverage Determinations
2023 Individual Creditability Coverage Determinations
2023 Small Group Creditability Coverage Determinations
2023 Large Group Creditability Coverage Determinations
Managing Group Enrollment and Eligibility
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Medicare Supplement Insurance Agent Portal
Applications—Group, Individual, and Short-Term
Click the application you would like to download:
2024 Employer Group Application
2024 Employee Group Application
Solicitud de grupo de empleados de 2024
2024 Employee Small Group Application - (No Medical Questions)
2024 WPS Health Insurance Individual Policy Application
2024 WPS Health Insurance Individual Transitional Policy Change Application
2024 Short-Term Application
2023 Employer Group Application
2023 Employee Group Application
Solicitud de grupo de empleados de 2023
2023 Employee Small Group Application - (No Medical Questions)
2023 WPS Health Insurance Individual Policy Application
2023 WPS Health Insurance Individual ACA Policy Change Application
2023 WPS Health Insurance Individual Transitional Policy Change Application
2023 WPS Health Plan Individual Policy Application
2023 WPS Health Plan Individual ACA Policy Change Application
2023 Short-Term Application
Visit
WPS Medicare supplement insurance
for more information
Enrollment Materials
Small Group Intake Checklist
Small Group Rating and Renewability Disclosure
Special Enrollment Period (SEP) Instructions – Individual On-Marketplace Only
Special Enrollment Period (SEP) Instructions – Individual Off-Marketplace Only
Special Enrollment Period (SEP) Instructions – Group
Authorization Agreement for Electronic Fund Transfers (EFT)
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