Wisconsin Insurance Plan

Applications

The Wisconsin Insurance Plan relies on the producer (insurance agent” or licensed intermediary) to secure the needed information from the applicant and from other sources to properly complete the application.

The Wisconsin Insurance Plan relies on the producer (insurance agent” or licensed intermediary) to secure the needed information from the applicant and from other sources to properly complete the application.

For use by producers only, not for customers

  • Complete on-line and print applications. You will need Adobe Acrobat Reader.
  • After you print the completed application, the producer must sign it. Mail it to the Plan with documentation of rejection. See Applying link on this website.

Online Applications