top of page

Loss of Coverage Documentation Needed for Marketplace Insurance Coverage

You would need to upload these documents because the federal government has requested additional documentation to verify your Loss of Coverage to complete your application for Marketplace insurance coverage. This is a common request, and as long as the required documents are submitted by the specified deadline, your health insurance coverage should not be impacted.

​

Once your documents are uploaded, our team will submit the documentation to the Marketplace for you.

We appreciate your prompt attention to this matter. Delays in submitting the requested documentation could result in interruptions or termination of your insurance coverage.

Acceptable Documents for Loss of Coverage Verification:

Below is a comprehensive list of acceptable documents to verify loss of coverage.  The document should include your name and address, date of coverage ending and must be on official stationary.

  • A letter from an insurance company

    • A letter or premium bill from your former insurance company that shows you or your dependent’s cancellation/termination from health coverage.

    • A decertification letter from your insurance company stating when coverage will no longer be offered.

  • A letter from an employer

    • That your employer dropped or will drop your coverage or benefits.

    • That your employer stopped or will stop contributing to your cost of coverage.

    • That your employer changed or will change coverage or benefits, and your coverage will no longer be considered qualifying health coverage.

  • A letter about COBRA coverage

    • Your employer’s offer of COBRA coverage along with the date this coverage would start.

    • Your COBRA coverage ended or will end, or your employer stopped or will stop contributing to the cost of coverage and when.

  • A health care program document

    • A letter from a government health program, like TRICARE, Veterans Affairs (VA), Peace Corps, or Medicare, showing when coverage ended or will end.

    • A letter from your state Medicaid or CHIP agency showing that your eligibility for Medicaid or CHIP was denied and when it was denied or that your Medicaid or CHIP coverage ended or will end.

    • A dated copy of your military discharge document (DD214).

  • A letter if you lost student health coverage

​

If one of the above documents is not available to you, you may submit one of the following documents, however it may include only some of the information needed and you will most likely need to submit more than one.

​

  • Pay stubs, if you lost employer-sponsored coverage. 

    • 2 pay stubs from the past 1-3 months, one that shows a deduction for health coverage and another which shows that the deduction ended in the past 60 days.

    • If a reduction in work hours caused you to lose coverage, you can submit one previous pay stub that shows that you worked 30 or more hours and a deduction for health coverage, and a pay stub from the past 60 days that shows that you worked less than 30 hours and no deduction for health coverage.

  • Document showing you lost coverage because of divorce, legal separation, custody agreements, or annulment within 60 days of submitting your application

    • Divorce or annulment papers that show the date responsibility ends for providing health coverage or proof that you stopped getting health coverage because of your relationship to your former spouse.

    • Legal separation papers that show the date responsibility ends for providing health coverage.

    • Other confirmation that you lost or will lose coverage because of divorce, legal separation, or annulment that shows the date that health coverage ends.

  • Document showing you lost coverage due to death of a family member

    • A death certificate or public notice of death and proof that you were getting health coverage because of your relationship to the deceased person, like a letter from an insurance company or employer that shows the names of the people on the health plan.

    • Other confirmation that shows you lost or will lose coverage because of the death of a spouse or other family member.

bottom of page