Notices

Open Enrollment Notices

• Marketplace Open Enrollment and Annual Redetermination Notices (September 2020)
  • English | Spanish
• Marketplace Automatic Enrollment Confirmation Messages (January 2020)
  • English | Spanish

Eligibility Notices

• Marketplace 2021 Eligibility Determination Notice (October 2020)
  • English | Spanish
• Marketplace 2020 Eligibility Determination Notice (October 2019)
  • English | Spanish
• Marketplace Eligibility Determination Notice: Plan Category Limitation (March 2019)
  • English | Spanish
• Marketplace Eligibility Determination Notice: Special Enrollment Period Pre-enrollment Verification (February 2018)
  • English | Spanish
• Marketplace Eligibility Determination Notice: Individual Coverage HRA and QSEHRA (July 2020)
  • English | Spanish

Special Enrollment Period Pre-enrollment Verification Notices

• Notice of pended plan selection 
  • English | Spanish
• Reminder notice
  • English | Spanish
• Warning notice
  • English | Spanish
• Insufficient documentation notice
  • English | Spanish
• Resolution notice
  • English | Spanish
• Expiration notice
  • English | Spanish  

Cross-Issuer Notices

• Official Notice to Consumers (October 2019)
  • English | Spanish

Data Matching Notices

• Marketplace Combined Data Matching Warning Notices (November 2016)
  • English | Spanish
• Marketplace Data Matching Citizenship Insufficient Documents Notices (November 2016)
  • Birth certificate only
    • English | Spanish
  • Damaged or unreadable
    • English | Spanish
  • Driver’s license only
    • English | Spanish
  • Social Security Card
    • English | Spanish
  • Wrong person
    • English | Spanish
• Marketplace Data Matching Citizenship/Immigration Resolution Notices (November 2016)
  • Trusted data source (Department of Homeland Security) resolved
    • English | Spanish
  • Resolved by sending in documents
    • English | Spanish
  • Resolved after coverage expired
    • English | Spanish
• Marketplace Data Matching Expiration Notices (November 2016)
  • English | Spanish

Periodic Data Matching Notices

• Special Medicare Notice for Consumers Turning 65 (January 2020)
  • English | Spanish
• Estate Initial Notice (July 2019)
  • English | Spanish
• Estate Response Notice (July 2019)
  • English | Spanish
• Estate Final Notice (July 2019)
  • English | Spanish
• Death Periodic Data Matching External Frequently Asked Questions (July 2019)
• Medicare (July 2020)
  • English | Spanish
• Medicaid and CHIP: final notice/ending financial help (September 2020)
  • English | Spanish
• Medicaid and CHIP: initial warning notice (September 2020)
  • English | Spanish

Account Transfer Notices (August 2019)

• Marketplace Inbound Account Transfer
  • English | Spanish
• Marketplace Outbound Response Account Transfer
  • English | Spanish

Tax Information

• Marketplace Tax Form 1095-A Cover Page (January 2019)
  • English | Spanish
• Marketplace Tax Form 1095-A Cover Page for Corrected Forms (January 2019)
  • English | Spanish
• Marketplace Tax Form 1095-A Cover Page for Voided Forms (January 2019)
  • English | Spanish
• Failure to Reconcile Open Enrollment Warning Notices (September 2018)
  • English | Spanish
• Failure to Reconcile Recheck Warning Notices (July 2020)
  • English | Spanish