Following is a January 28 notice from the Centers for Medicare and Medicaid Services, seeking public comment on application forms as it prepares to launch health insurance exchanges, now rebranded as “health insurance marketplaces,” in the fall of 2013:

CMS is seeking public comment on the new single, streamlined application for health insurance and the SHOP applications in preparation for the launch of a new Health Insurance Marketplace next fall.  Model applications and documentation for individuals and small businesses (SHOP) are now available for public comment via the paperwork reduction act (PRA).

The individual application is a single point of entry to purchase private insurance on the Marketplace and assess eligibility for assistance including, Medicaid, CHIP, and the Advanced Payment of Tax Credits.  People are asked to review the paper and online applications.  To demonstrate how users may interact dynamically with the online application, CMS has posted two videos of the applicationbeing completed.  One follows a family of three and the other an individual.

If you would like to see the video demonstrations, they are available at

SHOP applications for both employers and employees are posted in separate paperwork reduction act packages.

All PRA packages are available at:  When you reach that site, the packages can be found under the following titles and numbers. 

Individual Application

•  Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Affordable Insurance Exchanges, Medicaid and Children’s Health Insurance Program Agencies (CMS-10440)

SHOP Employer

•  Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439)

SHOP Employee

•  Data Collection to Support Eligibility Determinations and Enrollment for Employees in the Small Business Health Options Program (CMS-10438)

We appreciate your thoughtful comments to make this a better process for everyone.

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