Affordable Care Act Form Templates

This document is used for providing information about COBRA continuation coverage and how to elect it.

This Form is used to collect information related to the Affordable Care Act and its provisions. The form helps individuals provide the necessary details for assessing their eligibility and enrolling in health insurance plans under the Affordable Care Act.

This Form is used for reporting and reconciling excess premiums paid for COBRA coverage.

This document is used for verifying eligibility for the Premium Tax Credit, a subsidy provided by the government to help lower-income individuals and families afford health insurance.

This form is used for filing whistleblower complaints under the Affordable Care Act with OSHA.

This document is an application form to register as a non-navigator in the state of Louisiana. It is used by individuals or organizations who wish to assist others in navigating the healthcare system, but are not licensed insurance agents or brokers.

Use this document, otherwise known as the IRS Health Coverage Form, for submitting a report to the Internal Revenue Service (IRS) and to taxpayers about individuals with minimum essential coverage who are not liable for the individual shared responsibility payment.

This form is also known as the healthcare marketplace tax form. It is used to inform the IRS about individuals and families enrolled in a health plan via the Health Insurance Marketplace.

This is an IRS legal document completed by individuals who need to figure out the amount of their Premium Tax Credit and reconcile it with the Advanced Premium Tax Credit (APTC) payments made throughout the reporting year.

This Form is used for reporting Health Coverage Exemptions to the IRS and provides instructions for calculating your Shared Responsibility Payment.

This document is used for submitting the Affordable Care Act (ACA) compliance form filing submission worksheet for student health in Pennsylvania. It helps ensure that student health plans comply with the ACA regulations.

This Form is used for applying for health coverage and financial assistance in Hawaii. It provides instructions on how to complete the DHS1100 Application accurately.

This Form is used for renewing medical assistance for Magi-Excepted Households in Hawaii. It provides instructions for completing the renewal form DHS1100B-2.

This document is an application form for health insurance in Colorado. It also provides assistance for paying health insurance costs.

This Form is used for applying for health coverage and financial assistance in the state of Vermont.

This document provides a reference chart for the Special Enrollment Periods under the Health Reform. It helps individuals understand when they may be eligible to enroll in health insurance outside of the regular open enrollment period.

This document provides information about the new health insurance marketplace coverage options and how they may affect your current health coverage. It explains the benefits and enrollment process for these new options.

This document provides information on how the Affordable Care Act affects individuals and families. It includes details on coverage options, eligibility requirements, and potential penalties for not having insurance.