Step 1/2: Household Information

Zip Code*:
Household Income* (Combined income of the family members for the coverage year)
Email*:
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Step 2/2: Coverage Information

Household Size* (Tax filer + any spouse/dependents; even they aren't applying for insurance):
How many people need coverage?*:
Age of People Needing Coverage* (e.g., 25, 45,..):
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