Essential Tools

• You can review training and training resources through Pathlore
• Account Request Form (PDF)
• Application for Health Coverage & Help Paying Costs (DHS-6696) (PDF)
• Application for Certain Populations (DHS-3876) (PDF)
• Assister Authorization/Agent of Record (PDF)
• Assister Case Status Request (Excel)
• Background Study Consent (PDF)
• Enrollment Report: Privacy and Security Policies Questionnaire (PDF)
• Federal Tax Information (FTI) Authorization Form for 2019 Coverage (PDF)
• How to Access Online Training (PDF)
• MNsure Application for Health Coverage (DHS-6741-Eng) (PDF)
• MNsure Partner Event (PDF)
• Life events (report a change) reporting:
  • Report Changes
  • How to use the online reporting forms
  • Avoiding Common Errors in Reporting Life Events (PDF)
• Navigator Case Association Form (PDF) (5-2018)
• Online Navigator Case Association Form (5-2018)
• Request to Update Authorized Contacts (PDF) (12-2016)
• Roster template - CAC organizations (Excel) (9-2016)
• Roster template - navigator organizations (Excel) (9-2016)
• Special Enrollment Periods
  • Qualifying Life Events
  • Special Enrollment Period and Pre-enrollment Verification Guide for Assisters 2018 (PDF) (updated 4-2018)
  • Verification documentation cover letter
  • Verification document upload site

DHS Essential Tools

• MHCP Eligibility Policy Manual - provides eligibility policy for the health care programs administered by the Minnesota Department of Human Services
• General Consent/Authorization for Release of Information (DHS 3549) - the form assisters should use to authorize DHS-HCEO, a county, or tribal agency to share information regarding a consumer’s application and enrollment status