Insurance Plan Request

NOTE: Some companies have easy, one sheet pages that list plan specifics, others are 20 pages long.

Be specific in your request for information

Request for Plan Information

STEP ONE: Complete & Sign a Scope of Appointment Form (required by Centers for Medicare & Medicaid services)
Click below to submit Formal Request to Receive Information about Plans
HERE: https://bridlewoodinsurance.com/agent/mary-hansen/soacms

STEP TWO: Select Below what you are interested in
Click Here to Submit Request: https://forms.gle/igLbLvncurWb2DRG9

IMPORTANT NOTE: Depending on the number of plans you wish to see, your request will be completed in a timely fashion. If you have concerns, call the office at 303-548-2841

Request for 2026 details regarding your current plan

* Indicates required field

Name *

First

Last

Name of Current Plan *

Email *

Any additional questions? *

Do you wish to have your licensed agent reach out to discuss possible alternatives? *

No thank you, I'm happy with my plan Yes please.

*** If you request additional plan information besides your current plan, you will be contacted to schedule a time to discuss what you are looking for.

Disclaimer: *

By checking the box you are agreeing to discuss the indicated Insurance plans with a sales agent. I understand that I am under no obligation to enroll, my current or future Medicare enrollment status will not be impacted, and automatic enrollment will not occur.

Submit

NOTE: Some companies have easy, one sheet pages that list plan specifics, others are 20 pages long.​Be specific in your request for information

Request for Plan Information

Request for 2026 details regarding your current plan

NOTE: Some companies have easy, one sheet pages that list plan specifics, others are 20 pages long.

Be specific in your request for information