Forms & Documents

CMS requires health insurance agents obtain a customer’s consent prior to helping them apply for a subsidy and/or enroll in a Marketplace Qualified Health Plan

Use this form if you applied for Marketplace coverage need to submit documents to confirm annual income.

Use this form if you applied for Marketplace coverage need to send documents to confirm information on the application.

Use to provide a written explanation if clients cannot submit other requested documents to confirm a life event, such as loss of coverage, moving, or marriage, in order to qualify for a special enrollment period.

Use this worksheet to help gather information about employers that offer traditional health coverage to anyone on a Marketplace application.