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To be considered for Wisconsin Health Insurance Risk-Sharing Plan (HIRSP) coverage, applicants are required to:

1. Answer all questions completely to permit HIRSP to process the application. In order to process the application, HIRSP needs the applicant’s Social Security Number and certain other personally identifiable information. Providing this information is voluntary. However, since HIRSP uses this information to determine eligibility, we cannot process the application without it. The personally identifiable information and Social Security Number will be kept confidential and used only in our administration of the HIRSP program, as authorized by Chapter 149, Wisconsin Statutes and federal law.
2. Submit separate applications and separate premium payments for each applicant.
3. Submit supporting documentation required to process the application.
4. To receive additional information regarding the HIRSP Plan call 1-800-828-4777

Also, to complete your application, you may need the following:

• Software: Adobe Acrobat Reader Download
• Current/Recent Insurance Information: Employer Health Insurance
• Other Medical Coverage
• Medicaid/Medicare Information

Apply online now!