Notices

Open Enrollment Notices

• Marketplace Open Enrollment and Annual Redetermination Notices (September 2023)
  • English (ZIP) | Spanish (ZIP)
• Marketplace Automatic Enrollment Confirmation Messages (December 2023)
  • English (ZIP) | Spanish (ZIP)
• Bronze to Silver for Cost Sharing Reductions Notices (October 2023)
  • English (ZIP) | Spanish (ZIP)
• Cross-Issuer Notices (October 2023)
  • English (PDF) | Spanish (PDF)

Eligibility Notices

• Marketplace 2024 Eligibility Determination Notice (October 2023)
  • English (ZIP) | Spanish (ZIP)
• Marketplace 2023 Eligibility Determination Notice (October 2022)
  • English (ZIP) | Spanish (ZIP)

Marketplace Reminder Letters

• Loss of Medicaid/CHIP Reminder Letters
  • English (ZIP) | Spanish (ZIP)

American Rescue Plan Notices (July 2021)

• ARP Increased Financial Assistance Notice
  • English (PDF) | Spanish (PDF)
• ARP Eligibility Notice and Reenrollment Notice
  • English (ZIP) I Spanish (ZIP)

Data Matching Notices

• Warning Notices (April 2021)
  • English (ZIP) | Spanish (ZIP)
• Action Required Notices (Annual Income or Citizenship/Immigration Status) (April 2021)
  • English (ZIP) | Spanish (ZIP)
• Resolution Notices (Annual Income or Citizenship/Immigration Status) (April 2021)
  • English (ZIP) | Spanish (ZIP)

Periodic Data Matching Notices

• Special Medicare Notice for Consumers Turning 65 (June 2023)
  • English (PDF) | Spanish (PDF)
• Estate Initial Notice (September 2022)
  • English (PDF) | Spanish (PDF)
• Estate Response Notice (September 2022)
  • English (PDF) | Spanish (PDF)
• Estate Final Notice (September 2022)
  • English (PDF) | Spanish (PDF)
• Death Periodic Data Matching External Frequently Asked Questions (PDF) (July 2019)
• Medicare (September 2023)
  • English (ZIP) | Spanish (ZIP)
• Medicaid and CHIP: final notice/ending financial help (September 2020)
  • English (PDF) | Spanish (PDF)
• Medicaid and CHIP: initial warning notice (September 2020)
  • English (PDF) | Spanish (PDF)

Account Transfer Notices (August 2022)

• Marketplace Inbound Account Transfer
  • English (PDF) | Spanish (PDF)
• Marketplace Outbound Response Account Transfer
  • English (PDF) | Spanish (PDF)

Tax Information

• Marketplace Tax Form 1095-A Cover Page (December 2023)
  • English (PDF) | Spanish (PDF)
• Marketplace Tax Form 1095-A Cover Page for Corrected Forms (December 2023)
  • English (PDF) | Spanish (PDF)
• Marketplace Tax Form 1095-A Cover Page for Voided Forms (December 2023)
  • English (PDF) | Spanish (PDF)
• Failure to Reconcile Open Enrollment Warning Notices (November 2020)
  • English (PDF) | Spanish (PDF)
• Failure to Reconcile Recheck Warning Notices (July 2020)
  • English (ZIP) | Spanish (ZIP)

Special Enrollment Period (SEP) Notices

• SEP Notices for Marketplace enrollees
  • English (ZIP) | Spanish (ZIP)