Employer Coverage Tool - marketplace.cms.gov
EMPLOYEE information Fill out boxes 1–3 about the employee who’s offered job-based health coverage. 1. Employee name (First, Middle, Last) 2. Employee Social Security Number (SSN) 3. List the first and last names of each person in the employee’s household and tell us if they could get health coverage through the employer named in box 4
Download Employer Coverage Tool - marketplace.cms.gov
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