Step 1: Schedule A Health Insurance Phone Call
Brian Groberg, NPN: 20009630
Please select a time review your quotes and options with me:
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Important Notes
To help you make the most of your appointment, please consider having a computer available, and ensuring that any additional decision makers (like a spouse or parent) are available for the call as well.
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Step 2: Fill Out Our Health Insurance Research Form
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Household Infomation
Please list everyone who will be applying for coverage in your household (including yourself) for 2026:
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Are you currently married (or will you be married in 2026)? If so, will you file taxes jointly with your spouse for tax year 2026?
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Yes
No
Will you claim any dependents on your taxes for tax year 2026? If so, who?
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Is anyone in your household currently enrolled or eligible for another health insurance program like Medicaid, Medicare, CHIP, or an Employer Sponsored Plan? If so, who?
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Income Information
How much is each person in your household likely to earn in 2026? (For business or self-employment (1099) income, estimate your net income after business expenses. For regular or W2 income, estimate the total gross amount.)
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Total Estimated Household Adjusted Gross Income for 2026
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Total is calculated automatically. If your estimated Adjusted Gross Icome as a household is different that above, please enter the correct amount manually.
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Optional Information
Would you prefer to keep your same plan if available? Or would you prefer to switch to a new plan or insurance company?
What do you primarily expect to use your coverage for in 2026? Or what are the main things you want to make sure are covered well?
Which doctors (if any) would you like to keep in-network with your plan? (The actual names of the doctors are preferred as opposed to the name of a practice or location.)
What medications (if any) will you need coverage for? Or, what other pre-existing conditions (if any) need to be considered for coverage?
Is there anything that you wish could be different about your current health insurance plan?
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