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.
Name *
Your answer
Email Address
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 to information on CalFresh food assistance?
Any other information you would like us to know?
Your answer
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