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
sgoetsch@wausaumms.com

Sao Lao
715-841-1683
slao@wausaumms.com

Submit applications to:
WI Health Care Liability Insurance Plan
CitySquare Office Center
500 3rd St., Ste 700
Wausau, WI 54403

Email: whclip@wausaumms.com
Phone: 715-841-1690
Fax: 715-841-1697