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Enrollment and Eligibility (ENR) FAQ

Guidance for FAQ regarding Notices and FFM Notices

Program Area: Enrollment and Eligibility (ENR)

Question: What if the information on my Form 1095-A is incorrect because I didn't pay all of my premiums and my issuer terminated my enrollment?

Answer: If the consumer received a grace period from their issuer and then was terminated due to nonpayment of premiums, the consumer may not have an accurate termination date on their Form 1095-A. It is expected that the issuer will provide CMS with the accurate termination date and CMS will send the consumer a corrected Form 1095-A in this scenario. The consumer's monthly premium amounts for the months they were enrolled will show as the full monthly premium amount, even though the consumer may not have paid the issuer that full amount.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 12, 2015

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.