Health Insurance Enrollment Specialists at SDSU
Please complete this form to begin the process of connecting with an Enrollment Specialist about health insurance (Medi-Cal or Covered California Marketplace). You will hear back from someone within 2 business days.
Email address *
Name *
Your answer
Phone Number *
Your answer
Do you have health insurance? *
Would you like assistance applying for health coverage? *
Tax filling status *
What is your tax household size (The taxpayer(s) and any individuals who are claimed as dependents on one federal income tax return. A tax household may include a spouse and/or dependents). *
Your answer
Current Monthly Gross Income (before taxes are taken) *
Your answer
Do you want us to send you information about CalFresh food assistance? *
Any other information you would like us to know?
Your answer
A copy of your responses will be emailed to the address you provided.
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