Forms and Guides for Brokers

Find MNsure-certified broker forms here including MNsure paper applications, account request forms and more.

Applications

Miscellaneous Forms

Broker Case Status Request Form (Excel)
Federal Tax Information (FTI) Form (PDF)
Consumer Notice: Federal Tax Information (FTI)
Employer Health Coverage form-Appendix A (PDF) (for employees who enroll in individual coverage and whose employer offers small group coverage)

Report a Change

Special Enrollment Periods