Health Insurance Exchange Operations Chart
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Health Insurance Exchange Operations Chart *Chart updated June 12, 2015 Allison Wils As states continue to refine the operations of their health insurance exchanges, regardless of the exchange type (state-based exchange, state partnership exchange, or federally facilitated marketplace), it's helpful to compare and contrast operational resources. This chart contains each state's resources and forms for three distinct, and fundamentally important, areas of exchange operation: applications, appeals, and taxes. With links directly to the states' forms and guides related to these issue areas, this chart serves as a one-stop resource library for those interested in developing new, or revising old, versions of applications, appeals, and tax resources. Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. Know of something we should add to this compilation? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment, or email [email protected] with your suggestions. State Application Forms & Guides Appeal Forms & Guides Tax Guides IRS: Form 1095-A Health Insurance Marketplace Statement IRS: Instructions for Form 1095-A Health Insurance Marketplace Statement IRS: Form 8962 Premium Tax Credit IRS: Form 8965 Health Coverage Federally-Facilitated Marketplaces Healthcare.gov: Appeal Request Exemptions Healthcare.gov: Application for (FFM) & State Partnership Form for Wyoming Marketplace (SPM) States (AK, Health Coverage & Help Paying IRS: Instructions for Form 8965 AL, AR, AZ, DE, FL, GA, IA, IL, IN, Costs Healthcare.gov: Appeal Request Health Coverage Exemptions KS, LA, ME, MI, MS, MO, MT, NC, Form for Select States (Group 1) Healthcare.gov: Instructions to IRS: Affordable Care Act Tax ND, NE, NH, NJ, OH, OK, PA, SC, Help You Complete Your Provisions SD, TN, TX, UT, VA, WA, WV, and Healthcare.gov: Appeal Request Application for Health Coverage Form for Select States (Group 2) WY) IRS: Pub. 5187 Health Care Law - What's New for Individuals and Families IRS: The Premium Tax Credit IRS Notice: Penalty Relief Related to APTC for 2014 IRS Tax Tip: Individual Shared Responsibility Changes to 2014 Tax Return Covered California Form 1095-A Covered California: Paper Covered California: Appeal FAQs California Application Request Form Covered California Job Aid for Form 1095-A Connect for Health Colorado: Connect for Health Colorado: Connect for Health Colorado: Tax Colorado Paper Application Appeal Request Form Information and Form 1095-A Access Health CT: SHOP Access Health CT: Tax Information Employer Appeal Request Form Connecticut ** Access Health CT: Calculation, Access Health CT: SHOP Amending, and Reconciliation of Employer Appeals Process the Premium Tax Credit DC Health Link: Appeal Rights DC Health Link: Form 1095-A DC Health Link: Paper Application FAQs District of Columbia for Health Coverage and Help DC Health Link: Appeal Request Paying Costs Form for Individual/Family Health DC Health Link: 2014 Tax Coverage Information Hawaii Health Connector: Tax Hawaii Health Connector: Appeal Hawaii ** Information for Individuals and Request Form Families Your Health Idaho: Cost-Savings Your Health Idaho: Appeal Idaho Your Health Idaho: Tax Information Application for Health Coverage Request Form Kynect: Paper Application - No Kynect: Tax Form 1095-A Quick Kentucky Kynect: File a Complaint Help Paying Costs Reference Guide Maryland Health Connection: Maryland Health Connection: Information to Request Paper Maryland Health Connection: Maryland Health Connection: Maryland Application (must contact directly Request for a Fair Hearing Form 1095-A FAQs to request paper application) Massachusetts Health Connector: Massachusetts Health Connector: Massachusetts Marketplace and Massachusetts Paper Applications Appeals Information & Resources MassHealth Coverage at Tax Time MNsure: Application for Health Coverage and Help Paying Costs Minnesota MNsure: Appeal Request Form MNsure: Form 1095-A FAQs MNsure: Paper Application for Health Coverage (Unsubsidized) Nevada Health Link: Appeal Nevada Health Link: 2014 Tax Nevada ** Cheat Sheet Information Be Well NM: How to Enroll – Paper Be Well NM: Fact Sheet on Health Be Well NM: Appeals Information New Mexico Application (paper application is Coverage and Federal Income &Resources linked to healthcare.gov) Taxes New York State of Health: Premium Tax Credits and Form NY State of Health FAQs (appeals New York ** 1095-A Information information at bottom of page) New York State of Health: Form 1095-A FAQs Cover Oregon: Paper Application for Health Coverage and Financial Cover Oregon: Appeal Rights & Oregon Assistance Cover Oregon: Form 1095-A FAQs Process Cover Oregon: Paper Application for Private Health Insurance HealthSourceRI: Paper Application Health Source RI: Consumer FAQs Rhode Island ** for Health Care Coverage for the 2014 Tax Season Vermont Health Connect: Paper Vermont Health Connect: Appeals Vermont Health Connect: Tax Vermont Application for Health Coverage Information & Resources Filing FAQs and Help Paying Costs Washington Health Benefit Washington Health Benefit Washington Health Plan Finder: Washington Exchange: Appeals Information & Exchange: Tax Resources and Paper Application Resources 1095-A FAQs Notes: ** Denotes where information was not available through public web searches as of June 4, 2015. Topics: Insurance Exchanges Federal Exchange.