In an effort to meet the enrollment challenges that many are facing under healthcare reform,  Total Benefit Solutions Inc has designed a custom form for our clients to use. Using this form and submitting it to Total Benefit Solutions Inc  will enable our Marketplace trained and certified licensed independent brokers to assist you in the enrollment process from the registration right through the enrollment! Remember as your independent broker we always work in your best interests,  not an insurance company. We represent you, our client and not an insurer or government agency.

Click the link below to open the form and get started!  When completed, just click the link to attach it to an email, or print and fax it to our toll free secure fax at 1 (888)287-3186. It couldn’t get any easier!

Get the form and get started!


Don't Stress! We can help!
Don’t Stress! We can help!