We’re committed 
        to your Peace of Mind !
Kostyk Insurance Agency
OPTIONS OUTSIDE OF OPEN ENROLLMENT  
Please Fill Out the Below Form and I Will Get Back to You Within 24 Hours To Confirm Your Appointment
Renewal of a grandfathered or non-grandfathered individual major medical plan.

  •    Return from active military duty.
  •   Release from incarceration.
  •   Gain of immigration status or citizenship.
  •   Permanent move to a new state. 

 Loss of minimum essential coverage due to:

  • Discontinuation of a current plan that does not meet health care reform requirements.
  • Legal Separation or Divorce
  • Termination of a domestic partnership
or civil union
  • Change in full time employment status
Involuntary loss of employer-sponsored insurance
  • Death of a parent or spouse
  • Change in dependent status as a
result of turning 26

Gaining or becoming a dependent due to:

  • Marriage
  • Domestic partnership
  • Birth of child/children
  • Adoption of a child/children
  • Placement for adoption of a child or children
  • Guardian/court-ordered dependent

Customers can apply 60 days prior to the 
life event date.

Customers must apply no later than 60 days after their life event.

Required documentation is needed for all triggering events. 
Please contact us regarding your specific situation.
Please  Call or E-Mail Susan 
For An Appointment