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Event Participation Request

Get Covered Illinois (GCI) looks forward to discussing Open Enrollment and the Special Enrollment Period for Healthcare.gov. We can present information, answer questions, and share resources at your event (including live streaming events, webinars, or recorded presentations).

You will receive an email to confirm that your request is received. Then, the GCI team will reach out to you to discuss your request.

We will accommodate as many requests as scheduling permits. If your event is scheduled, you will receive another email confirming GCI’s participation. Should you need to cancel an event, please send an e-mail no later than two business days before the scheduled event to brian.gorman@illinois.gov.

Please submit only one request per event.

* indicates required field

  1. Separator
  3. Separator
  5. Event Title
  6. Host
  7. Event Begin Date
  8. Event Begin Time
  9. Event End Time
  10. Location
  11. Event Description/Purpose
  12. Format
  13. Other Format
  14. Separator
  16. Separator
  18. Organization
  19. Requestor Name
  20. Requestor Title
  21. Contact Email
  22. Contact Phone Number
  23. CAPTCHA

Event Information

Please enter information related to the location, date/time and formation of the event for which our presence or participation is being requested.

Please supply a host or sponsor for the event.

Supply Street/City, if online event please supply platform or leave blank if undermined or unknown.

Please supply a brief description or purpose of the event.

Please select the format of the event from the available choices, if other please supply in the box provided.

Requestor Information

Please enter requestor contact information, this information will be used if additional information is required for scheduling or decision making purposes.

Please supply first/last name.

Ex. President, Organizer, Chair, etc..

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A division of the Illinois Department of Insurance

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Get Covered Illinois
Information: 1-866-311-1119

Healthcare.gov

Illinois Department of Insurance
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Springfield: (217) 782-4515

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