Instructions
1. Select the application.
2. Download to your device.
3. Complete and sign.
4. Submit the application.
Applications
Within eight business days after receiving an application, the plan shall notify the applicant whether the application is accepted, rejected or held pending further investigation. Any applicant rejected by the plan may appeal the decision to the board.
If you have questions regarding the application please contact:
Shayna Goetsch
715-841-1685
[email protected]
Sao Lao
715-841-1683
[email protected]
Submit applications to:
WI Health Care Liability Insurance Plan
CitySquare Office Center
500 3rd St., Ste 700
Wausau, WI 54403
Email: [email protected]
Phone: 715-841-1690
Fax: 715-841-1697