Income Attestation Form 2024 Plan Summary Trio HMO Payment MEC

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Starts 10/1/23 thru 1/31/24

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CoveredCA Renewal FORM

Los Angeles - Orange County - San Diego - Riverside - Sacramento - And More!

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Serving ALL of California Since 1998
949-713-7222

Need Help Renewing with CoveredCA.com?

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Open Enrollment 2024

Open Enrollment 2022

Phone # for Friend 2:

Your Email: *

SURVEY

Address where we can send your GIFT CARD:

Thank you for taking 2 minutes to complete our short form

2) Are you satisfied with our "5 Star" Service?:

Yes! I am extremely happy with my Certified Agent Marc Harris, and would like to refer 2 people today so I can qualify for my Gift Card (Valued at up to $25.00)

GIFT CARD Eligibility (Please Check Box Below):

I understand that in order to qualify for my GIFT CARD (Value up to $25) I must complete all boxes on this survey (including 2 referrals with Name, Valid Phone Number and Email address)

Refer a friend, neighbor, co-worker, etc - we would love to help them out!

Your Name (First and Last): *

Provide a Testimonial or any Comments (if you like):

Phone # for Friend 1:

Select Your GIFT CARD (Valued at up to $25.00)

Thank you for taking the time to complete our survey and for referring a friend or 2. In order to qualify for the GIFT CARD, (2) complete referrals must be submitted (including Name, Valid Phone # and Email). Thanks again :)

Email for Friend #1: *

Email for Friend #2:

1) How did your agent help? (Check All That Apply): *

Sent me my 1095-A Tax Form

Updated my Income, Address, Family Member, Etc.

Discussed DENTAL INSURANCE options

Talked about VISION INSURANCE

Offered me Low Cost LIFE INSURANCE

Helped with a Medicare Supplement (Age 65+)

Completed my Annual Health Insurance Review at no charge (FREE Service once per year)

Other

We offer other types of insurance!

- DENTAL Insurance for $18.95/mo.

- VISION Insurance as low as $9.50/mo

- Low Cost LIFE Insurance

- Medicare Supplement (Age 65+)

Welcome to our family of Covered California clients. Our job is to help assist you for all your insurance needs. Thank you for taking 2 minutes of your time!

Meet Marc Harris
Your Local Certified Insurance Agent

I have been helping clients since 1998 and
was one of the first agents to get certified
with Covered California and the CoveredCA.com
Exchange. We launched OE15.com to make it easy for clients like you evaluate all of your opportunities, and enroll in the policy with the best value. STOP waiting on hold for hours and START getting the service you deserve. Ready to renew your policy? We can help you today! Complete our short form and someone will contact you.

Certified Insurance Agent: Marc Harris
Covered California Agent ID#: 2000016310
Date Certified: 10/29/2013
Certification #: 5000003622
PDF Download:Covered California Certificates
website: www.OE15.com
CA Insurance License #: 0C45052

no additional fee to use us!

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Tell Us How We Did.

Covered California Client Survey
REFER - A - FRIEND

Let others know about us so we can help!

Friends Name #2 (First and Last):

Friends Name #1 (First and Last): *