CHC Prospective Member Forms & Documents

Please note:
CHC is not taking new enrollments at this time

Cooperative Health Choices of Western Wisconsin (CHC) and WPS Health Insurance (WPS) jointly announce that CHC’s insurance pool is now open to all eligible groups (businesses located in CHC’s 17-county region).

Please contact an Accredited Broker for additional details.
List of CHC Accredited Brokers

Important First Step:
All prospective CHC members are asked contact a CHC Accredited Borker to discuss details of the CHC Health Plan and potential enrollment. To assist in selecting a broker, a list of CHC Accredited Brokers is available for review (use link above). CHC suggests that multiple brokers are interviewed before selecting one.

Before becoming a CHC member, businesses will need to complete the CHC Broker Selection Form (use link below) to indicate their broker preference. The broker designated on your CHC Broker Selection Form will be your agent of record and will service your account in the future. You must contact your broker directly to discuss plan details, rate information, and the enrollment timeline.

CHC Broker Selection Form

CHC Member Application

CHC 3-Year Insurance Agreement

Learn More:

The Basics of Health Savings Accounts (HSAs)

The Basics of a Consumer Driven High Deductible Health Plan with a Health Savings Account