Medical ACA Enrollment Form - Utah

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Medical ACA Enrollment Form - Utah

Medical ACA Enrollment Form is a legal document that was released by the Utah Department of Human Resource Management - a government authority operating within Utah.

FAQ

Q: What is the purpose of the Medical ACA Enrollment Form?
A: The purpose of the Medical ACA Enrollment Form is to enroll in a health insurance plan through the Affordable Care Act (ACA).

Q: Who can use the Medical ACA Enrollment Form in Utah?
A: Residents of Utah who do not have access to employer-sponsored health insurance can use the Medical ACA Enrollment Form to enroll in a health insurance plan.

Q: What information do I need to provide on the Medical ACA Enrollment Form?
A: You will need to provide personal information, such as your name, address, Social Security number, and income information, as well as information about your household members.

Q: When is the deadline to submit the Medical ACA Enrollment Form in Utah?
A: The deadline to submit the Medical ACA Enrollment Form in Utah is usually in mid-December, but it can vary each year. It is important to check the specific deadline for the current enrollment period.

Q: Can I get financial assistance with my health insurance premiums through the Medical ACA Enrollment Form?
A: Yes, you may be eligible for financial assistance through the Medical ACA Enrollment Form based on your income and household size.

Q: What happens after I submit the Medical ACA Enrollment Form?
A: After you submit the Medical ACA Enrollment Form, the Utah Health Insurance Exchange will review your application and determine your eligibility for health insurance coverage. You will be notified of your enrollment status and provided with plan options.

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Form Details:

  • Released on May 19, 2015;
  • The latest edition currently provided by the Utah Department of Human Resource Management;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Utah Department of Human Resource Management.

Download Medical ACA Enrollment Form - Utah

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