Let's get started!

Kathy Wills

kathy@wiswellinsurance.com

www.calendly.com/kathywills

I'm excited to help you with your health insurance!

The first step is to complete the form below with as much information as possible. This enables me to better understand your needs and pull accurate quotes. Once you submit the form, you will receive two emails:

First, you'll receive a confirmation email with a link to schedule a call with me.
Next, you'll receive an email titled: Rx Collect - Requested Updates. We've updated our technology so our clients can more easily relay information regarding their providers and prescriptions. Follow the instructions in the email to access the search tool and let us know what in-network providers and prescriptions you need.

If you don't receive these emails or if you have any questions, please send an email to contact@wiswellinsurance.com.

Tell Me About Yourself!

Please complete each field as thoroughly as possible so I can provide you with accurate quotes.

Please review the form.

First Name *

Last Name *

Email *

Phone Number *

Date of Birth *

Family members, if applicable. (Include names and dates of birth.)

Zip Code (If home and mailing addresses are different, use home address). *

County (If home and mailing addresses are different, use home address). *

Household Income (An estimate of your Modified Adjusted Gross Income, or MAGI, for 2025. Please ask a tax professional if you are unsure; we are unable to advise regarding this.) *

When do you need benefits to start?

Please note, we are outside the open enrollment period (Nov 1 - Jan 15) and you will need a Qualifying Life Change Event to enroll in health coverage, such as marriage, the birth of a child, or loss of coverage. Please list your qualifying event and the associated date.

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