| 
				One
				commenter asked that we clarify whether electronic sources would
				be used for verification, and if so, asked that we add language
				to explain that applicants do not need to submit documentation
				until they are notified that electronic verification was
				unsuccessful. | 
				The
				final rules in subpart G of 45 CFR part 155 discuss verification
				procedures for exemptions. Where the applications specify that
				documentation must be provided initially, this is because
				electronic verification is not a primary option at this time. HHS
				remains committed to maximizing the use of electronic
				verifications for eligibility for exemptions. | 
		
			| 
				Commenters
				asked that we rename the application for members of Indian tribes
				and other individuals who are eligible for services through an
				Indian health care provider. | 
				We
				are renaming this application, “Application for Exemptions
				for American Indians and Alaska Natives and Other Individuals Who
				Are Eligible to Receive Services from an Indian Health Care
				Provider”. | 
		
			| 
				One
				commenter asked that we include the eligibility criteria for
				services through an Indian health care provider. | 
				We
				will be adding this in instructions that are posted alongside the
				application at a later date, after we have the opportunity to
				consult with stakeholders. | 
		
			| 
				Commenters
				stated that the existence of multiple exemption applications did
				not minimize paperwork. 
 
 | 
				We
				opted to create separate applications because the information
				needed for each type of exemption is different. A combined
				application would have been significantly longer and all
				individuals would have had to skip many sections. Accordingly, we
				are maintaining the existing approach. | 
		
			| 
				Commenters
				asked that we remove the optional race and ethnicity questions
				from the application for members of Federally-recognized tribes
				and other individuals who are eligible to receive services from
				an Indian health care provider. | 
				We
				opted to include these questions initially in order to promote
				consistency among the exemptions applications and to assist HHS
				in ensuring that all communities have equal access to the
				Marketplace. However, given the focus of this particular
				exemptions application, we have decided to remove these
				questions. | 
		
			| 
				Commenters
				asked that we remove questions and language regarding tax
				households from the application for members of
				Federally-recognized tribes and other individuals who are
				eligible to receive services from an Indian health care provider. | 
				Tax
				household information is needed so IRS can recognize an exemption
				certificate that is granted by a Marketplace on an individual's
				tax return. Accordingly, we are retaining these questions. | 
		
			| 
				Commenters
				asked that the exemption for individuals who are eligible to
				receive services from an Indian health care provider be available
				from IRS through the tax filing process, in addition to being
				available through the Marketplace. | 
				This
				is outside of the scope of this PRA package. We anticipate that
				IRS will make information available about the Marketplace process
				on tax forms and instructions. | 
		
			| 
				Commenters
				asked that we allow the Indian Health Service (IHS) to apply on
				behalf of individuals who are in IHS patient registration
				records. | 
				As
				we have previously discussed, we are committed to working with
				IHS to establish an electronic verification system that can be
				used for exemptions. However, we do not believe that the
				authority exists to facilitate having IHS apply on behalf of
				individuals, particularly without their knowledge or affirmative
				consent. We are working closely with IHS to help IHS providers
				quickly issue documentation that can be used by consumers as part
				of an application for an exemption. | 
		
			| 
				Commenters
				asked that we revise the application for members of
				Federally-recognized tribes and other individuals who are
				eligible to receive services from an Indian health care provider
				to use the term, “Indian tribe”, instead of “member
				of a Federally-recognized tribe”. | 
				We
				note that the language that is used in the statute is, “member
				of an Indian tribe, as defined in section 45A(c)(6) of the
				[Internal Revenue] Code”, and that we have previously used
				“member of a federally-recognized tribe” as a
				plain-language variation of this definition. With that said, we
				are modifying the application to use, “member of an Indian
				tribe”, noting that the change in phrase does not change
				the eligibility rules for exemptions. | 
		
			| 
				Commenters
				asked for clarification regarding whether the Marketplace would
				issue separate exemption certificate numbers for each member of a
				tax household who was found eligible for an exemption. | 
				The
				Marketplace will provide a separate exemption certificate number
				for each individual who is determined eligible for an exemption. | 
		
			| 
				Commenters
				asked whether an individual could list American Indian or Alaska
				Native languages in response to the preferred language question,
				and whether the application could inform individuals that
				assistance will be provided in tribal languages. | 
				The
				application is designed to allow an individual to write in any
				language in response to the preferred language question. However,
				for the first year of operations, the Federally-facilitated
				Marketplace will only provide written notices in English,
				although the notices will include tag lines to enable individuals
				to obtain assistance via phone in a number of different
				languages. In addition, Navigators and certified application
				counselors with different linguistic capabilities will provide
				assistance with exemptions applications. | 
		
			| 
				Commenters
				asked that we use the term, “tax penalty”, instead of
				“shared responsibility payment”. | 
				“Shared
				responsibility payment” is in line with the language used
				in section 5000A of the Code. As such, to minimize confusion, we
				are maintaining this language. | 
		
			| 
				Commenters
				asked that we clarify the first page of the application for
				members of Federally-recognized tribes and other individuals who
				are eligible to receive services from an Indian health care
				provider to clarify that the application is for two categories of
				exemptions. | 
				We
				have modified the application accordingly. | 
		
			| 
				Commenters
				asked that we clarify on the first page of the application for
				members of Federally-recognized tribes and other individuals who
				are eligible to receive services from an Indian health care
				provider that applicants must provide documents. | 
				We
				have modified the application accordingly. 
 | 
		
			| 
				Commenters
				asked that we allow for online submission of the exemption
				application. | 
				As
				discussed in the final exemptions rule, the Federally-facilitated
				Marketplace is unable to support online submission for the first
				year of operations. We remain committed to establishing an
				electronic process in the future. | 
		
			| 
				Commenters
				asked that we specify that a shareholder certificate or other
				proof of enrollment in an Alaska Native Claims Settlement Act
				regional or village corporation would be sufficient to document
				eligibility for an exemption. | 
				This
				is currently under review with the HHS Office of General Counsel.
				When the issue is concluded, we will update instructions and
				educational materials accordingly. | 
		
			| 
				Commenters
				asked that we add language to further clarify that if the
				Marketplace approves an exemption, the Marketplace will issue an
				exemption certificate number. 
 | 
				We
				have added language to clarify that after an application is
				completed, if an individual is determined eligible for an
				exemption by the Marketplace, the eligibility determination
				notice will include an exemption certificate number for use
				during the tax administration process. | 
		
			| 
				Commenters
				asked that we remove the question regarding an applicant’s
				relationship to the household contact. | 
				We
				have removed this question from all applications except for the
				applications for the exemptions for individuals who are unable to
				afford coverage, since this question is only critical for those
				exemptions. | 
		
			| 
				Commenters
				asked that we remove the question about whether an individual
				needs an exemption on the application for members of
				Federally-recognized tribes and other individuals who are
				eligible to receive services from an Indian health care provider
				and replace it with a check-box on the signature page. Another
				commenter asked that we remove this question on the application
				for individuals who are unable to afford coverage in a state with
				a state-based Marketplace and the hardship exemption application. | 
				This
				question is designed to facilitate situations in which a tax
				filer is not requesting the exemption, but they are requesting it
				for a tax dependent. If this is not checked, then the person is
				being provided only to establish the tax relationship, and is
				instructed that they can skip the remaining questions. If we
				shift this to the end of the application, it increases the risk
				that individuals will complete unnecessary questions.
				Accordingly, we are retaining it. | 
		
			| 
				Commenters
				asked that we remove the question on the application for members
				of Federally-recognized tribes and other individuals who are
				eligible to receive services from an Indian health care provider
				that asks an applicant who knows that his or her eligibility for
				services from an Indian health care provider will end to provide
				the end date. | 
				Without
				this question, the Marketplace will erroneously provide an
				exemption for months during which an individual is not eligible
				for services through an Indian health care provider. The majority
				of individuals who never lose eligibility can skip this question.
				Accordingly, we are maintaining it here. | 
		
			| 
				Commenters
				asked that we remove the language on the signature page for the
				application for members of Federally-recognized tribes and other
				individuals who are eligible to receive services from an Indian
				health care provider that specifies that an applicant must report
				any changes in the information that is listed on the application,
				unless specific examples can be provided. | 
				This
				language is needed in order to ensure that individuals who may
				only be temporarily eligible to receive services through an
				Indian Health Care provider understand that they need to notify
				the Marketplace when their eligibility ends, so as to ensure that
				they are not in receipt of an exemption when they are ineligible
				for it. Accordingly, we are maintaining this language. | 
		
			| 
				Commenters
				asked that we remove the language specifying that applicants
				could submit an appeal online. | 
				We
				have removed this reference as the online appeal function will
				not initially be available. | 
		
			| 
				Commenters
				asked that we re-label Appendix C as Appendix A. | 
				We
				have modified the applications accordingly. | 
		
			| 
				Commenters
				asked that we provide a list of documents that would be
				sufficient to establish eligibility for services through an
				Indian health care provider. | 
				We
				appreciate this suggestion, and are working on a list that we
				plan to include as part of an instructions package that will
				accompany the application. | 
		
			| 
				One
				commenter asked that we specify on the application that
				individuals must notify the Marketplace of any changes within 30
				days. | 
				We
				have included language regarding the requirement to report
				changes on all of the applications for which the underlying
				exemption has a change reporting requirement. Information on
				change reporting will also be included in eligibility notices for
				exemptions. | 
		
			| 
				One
				commenter asked that we establish guidelines for Marketplaces to
				use to review applications for fraudulent information. | 
				We
				appreciate this comment. However, this is outside of the scope of
				this Paperwork Reduction Act package. | 
		
			| 
				One
				commenter asked that we assure that paper applications would be
				available for all exemptions. | 
				Per
				45 CFR 155.610(d)(3), paper exemption applications will be
				available for all types of exemptions that are available through
				the Marketplace. | 
		
			| 
				One
				commenter asked that we provide clear explanations regarding
				which exemptions are available through IRS, which are available
				through the Marketplace, and which are available through both.  
				 | 
				We
				have included this information on each form, and will also look
				to make it available through educational materials and
				instructions. | 
		
			| 
				One
				commenter asked that we specify that an applicant must provide a
				Social Security number (SSN). The commenter also asked that we
				maintain and expand the use of language that specifies that it is
				helpful, but not required, to supply a SSN. | 
				We
				have expanded the language on each application to clarify that if
				a person is requesting an exemption for themselves and he or she
				has a SSN, he or she must provide the SSN. | 
		
			| 
				One
				commenter asked that we specify that application information will
				be verified electronically, and that personal information will be
				protected. | 
				The
				applications include standard language regarding privacy,
				consistent with the single, streamlined application for
				enrollment in a QHP through the Marketplace and insurance
				affordability programs. We anticipate providing additional
				information as we expand the use of electronic verification. | 
		
			| 
				One
				commenter asked that the applications be revised to support
				individuals with lower levels of literacy. 
 | 
				The
				Exemption applications follow the literacy level approved and
				established for the coverage applications – in fact, most
				of the language in the Exemption applications comes directly from
				the coverage applications which have been extensively
				consumer-tested. | 
		
			| 
				One
				commenter asked that HHS provide states with minimum standards
				for State-based Marketplaces regarding accepting the exemption
				application. | 
				We
				clarify that for 2014; State-based Marketplaces that are opting
				to have HHS administer the exemption process are not required to
				accept applications. Rather, they need to provide consumers with
				information regarding how to submit an application to HHS. | 
		
			| 
				One
				commenter asked that we simplify the titles of the applications. | 
				We
				have reviewed the titles of the applications and will be
				generally maintaining them, to ensure specificity about which
				application is for which exemption. We will explore ways to
				provide clear guidance on this topic through healthcare.gov and
				other educational materials. | 
		
			| 
				One
				commenter asked that we create a separate form for consumers who
				are applying for an exemption because employer coverage is
				unaffordable. | 
				After
				considering this comment, we have opted to maintain one
				application for individuals in FFM states and one application for
				individuals in SBM states, each of which addresses individuals
				regardless of whether they have employer-sponsored coverage. We
				took this direction because we know that there are situations in
				which an employer offers coverage only to the employee, in which
				case having separate applications for those with and without an
				offer of employer-sponsored coverage would result in families
				needing to submit multiple applications. | 
		
			| 
				One
				commenter suggested that we add page numbers to the applications
				and increase font size. | 
				We
				have added page numbers. Due to space constraints, we were unable
				to further increase the font size. | 
		
			| 
				One
				commenter asked that we remove the request for an application
				filer to initial at the top of each page. | 
				We
				have removed this in accordance with the comment. | 
		
			| 
				One
				commenter asked that we specify that an individual is eligible
				for an exemption even without a Social Security number, and that
				we use “Tax Identification Number” instead of Social
				Security number. | 
				The
				Marketplace does not use any type of taxpayer identification
				number besides a Social Security number. Accordingly, as we have
				on the single, streamlined application for enrollment in a QHP
				and insurance affordability programs, we ask only for a SSN. We
				do clearly describe that SSN is not required to obtain an
				exemption, and we are retaining this language. | 
		
			| 
				One
				commenter stated that we should not ask for citizenship or
				immigration status information on exemptions applications. The
				commenter also asked that we remove the language on the second
				page of the application for the exemption for individuals who are
				unable to afford coverage in certain states with a State-based
				Marketplace advising consumers that they do not need to provide
				information regarding immigration status for family members who
				don’t need an exemption,  the recommendation on the first
				page of the same application to have document numbers for legal
				immigrants who are asking for an exemption available as part of
				the application process, and the language on the last page of the
				same application specifying that information will be shared with
				the Department of Homeland Security. 
 | 
				Citizenship
				and immigration status information is only requested on the
				application for the exemption for individuals who lack affordable
				coverage in states in which there is a Federally-facilitated
				Marketplace, since this is the only exemption where the
				information is needed. It is needed for this exemption since a
				component of the exemption is determining the cost of the
				lowest-cost bronze plan net of advance payments of the premium
				tax credit, which requires the evaluation of eligibility for
				enrollment in a qualified health plan, Medicaid, and CHIP. As
				with all Marketplace processes, citizenship and immigration
				status information will be safeguarded and only used for the
				purpose of eligibility. 
 With
				that said, since the Marketplace does not need immigration status
				for anyone who is using the application for the exemption for
				individuals who are unable to afford coverage in certain states
				with a State-based Marketplace, we have removed all language
				addressing immigration status from that application. | 
		
			| 
				One
				commenter asked that we add language indicating that an
				individual whose application for an exemption is approved should
				retain the exemption certificate number provided by the
				Marketplace. | 
				We
				have added language on the cover page and on the second page
				consistent with the comment. | 
		
			| 
				One
				commenter asked that we move language regarding the right to
				appeal to the first page. | 
				We
				are retaining appeals language on the signature page, consistent
				with the single, streamlined application for enrollment in a
				qualified health plan through the Marketplace and insurance
				affordability programs. | 
		
			| 
				One
				commenter asked that we add language on the first page of each
				application to explain who should use each particular
				application. | 
				We
				have included this information in a section on the front page
				called, “Who can use this application?” | 
		
			| 
				One
				commenter asked that we clarify on each application that
				taxpayers with income below the filing threshold are already
				exempt, and as such, do not need to apply separately for an
				exemption. | 
				We
				are adding clarifying language on each application. 
 | 
		
			| 
				One
				commenter asked that we specify that one application can be used
				to request an exemption for everyone in a tax household. | 
				We
				have added this language. | 
		
			| 
				One
				commenter supported the existing language regarding keeping
				personal information secure and asked that we add information
				regarding the specific agencies with which the Marketplace would
				share information for verification purposes. | 
				We
				are retaining this statement. We strive to maximize secure
				electronic verification, and may enhance capabilities in this
				area during the year. The most updated information on data
				matching can be found within the privacy statement and system of
				records notice. | 
		
			| 
				One
				commenter asked that we reverse the order of the race and
				ethnicity questions; that we add “South America” and
				“Central America” under “Hispanic/Latino”;
				and that we add separate check-boxes for “South Asian”
				and “Southeast Asian” and remove “Asian Indian”
				and “Other Asian”. | 
				We
				are retaining this section as provided for public comment. We are
				maintaining the order of the questions to ensure operational
				consistency with the single, streamlined application for
				enrollment in a qualified health plan through the Marketplace and
				insurance affordability programs, and we are maintaining the
				proposed categories as they follow recommendations from the HHS
				Office of Minority Health in accordance with section 4302 of the
				Affordable Care Act. | 
		
			| 
				One
				commenter asked that we change appeals language on the signature
				page of the application to say, “If you don’t agree
				with the decision” instead of “If you don’t
				agree with what you qualify for”. | 
				We
				agree that the proposed language was unclear, and have modified
				it to read, “If you don’t agree with the results of
				your application”. | 
		
			| 
				One
				commenter asked that we define “affordability” on the
				applicable exemption applications, and that we add examples to
				illustrate when various coverage would be affordable or
				unaffordable. | 
				We
				will consider adding this as part of educational materials and
				instructions. | 
		
			| 
				One
				commenter asked that we add language to the applications for
				exemptions for individuals who are unable to afford coverage
				explaining that the applications are for individuals who did not
				have minimum essential coverage for the past tax year. | 
				These
				applications are intended to be filed prospectively, so we are
				maintaining the language as proposed. | 
		
			| 
				One
				commenter asked that we add language to the applications for
				exemptions for individuals who are unable to afford coverage
				specifying that there are also hardship exemptions available. The
				commenter also asked that we add language to the hardship
				exemption application to provide examples of who should not use
				the hardship exemption application. | 
				We
				anticipate providing information regarding the range of available
				exemptions on healthcare.gov. | 
		
			| 
				One
				commenter asked that we remove the section of the application for
				individuals who are unable to afford coverage in certain states
				with a State-based Marketplace that asks consumers to provide
				information regarding the lowest-cost bronze plan net of advance
				payments of the premium tax credit, and instead gather this
				information directly from the State-based Marketplace. The
				commenter also asked that we provide a single application for the
				exemption for individuals who lack affordable coverage instead of
				having one for individuals in certain states with state-based
				Marketplaces and another for individuals in states with a
				Federally-facilitated Marketplace. | 
				The
				Federally-facilitated Marketplace does not have access to
				person-specific information regarding eligibility for advance
				payments of the premium tax credit in a State-based Marketplace,
				due to states having their own rating information and
				state-specific eligibility rules for Medicaid and CHIP.
				Accordingly, we anticipate working with State-based Marketplaces
				to provide assistance to consumers in obtaining this information.
				The fact that the Federally-facilitated Marketplace does not have
				access to this information is why it is necessary to have
				separate applications for individuals in states with a
				State-based Marketplace and individuals in states with a
				Federally-facilitated Marketplace; if we were to use a single
				application, individuals in states with a State-based Marketplace
				would need to skip over the significant number of questions that
				are needed to determine the cost of the lowest-cost bronze plan
				for individuals in states with a Federally-facilitated
				Marketplace. Accordingly, in order to limit burden on
				individuals, we are maintaining separate applications. | 
		
			| 
				One
				commenter asked that we delete references to, “the
				exemptions process” on the first page of applications. | 
				We
				have removed this language. | 
		
			| 
				One
				commenter asked that we modify the information on the first page
				regarding next steps to specify that a decision will be rendered
				within 1-2 weeks and that the individual can immediately appeal
				the decision if he or she so desires. | 
				We
				believe that the language on the first page is adequate, and that
				the information regarding appeals is covered on the signature
				page, which is where it is more relevant. We are also concerned
				about adding redundant information to the front page, since this
				might require reducing the overall font size. Accordingly, we are
				maintaining the language as is. | 
		
			| 
				One
				commenter asked why the application for the exemption for
				individuals who are unable to afford coverage in certain states
				with a State-based Marketplace includes language advising
				consumers to obtain the policy numbers of any job-related health
				insurance. | 
				This
				was included erroneously. As such, we have removed it. | 
		
			| 
				One
				commenter asked that we add a worksheet to the applications for
				the exemptions for individuals who are unable to afford coverage
				to assist with calculating annual income, and why the
				applications collect annual income on a person-by-person basis. | 
				The
				approach to obtaining income information is identical to what is
				used in the paper version of the single, streamlined application
				for enrollment in a qualified health plan through the Marketplace
				and insurance affordability programs, and was developed and
				tested with consumers. This process is what resulted in a
				person-by-person income approach, which avoids some of the
				inaccuracy that is possible when asking for a lump sum of income
				across multiple family members and jobs. Accordingly, we will
				retain it for use in the exemptions process. As we gain
				experience from both the coverage and exemptions processes, we
				will look at ways to increase the usability of the income
				questions on both types of applications. | 
		
			| 
				One
				commenter asked that we add explicit language regarding the
				requirement to report changes within 30 days to the applications
				for the exemptions for individuals who are unable to afford
				coverage. | 
				As
				specified in 45 CFR 155.620(a) and (b), there is no change
				reporting requirement for these exemptions. The eligibility
				standards described in 45 CFR 155.605(g)(2)(vi) specify that
				these exemptions are provided for all remaining months in a
				coverage year, notwithstanding any change in an individual’s
				circumstances. Accordingly, we are not adding this language. | 
		
			| 
				One
				commenter asked why information provided by an individual as part
				of an application for the exemptions for individuals who are
				unable to afford coverage would be shared with a consumer
				reporting agency, objected to this data sharing, and stated that
				if the data sharing was necessary, then the consumer should
				explicitly consent to it. | 
				The
				Federally-facilitated Marketplace uses a consumer reporting
				agency as part of the income verification process, in accordance
				with 45 CFR 155.615(f)(2)(i). As specified, the income
				verification process is the same as is used for eligibility for
				advance payments of the premium tax credit and cost-sharing
				reductions. Using information from the consumer reporting agency
				reduces the number of individuals who need to submit
				documentation to support their attested income, and does not
				affect an individual’s credit rating. 
				 | 
		
			| 
				One
				commenter asked that the information in the application regarding
				the appeals process be provided in a frequently-asked-questions
				document. | 
				We
				appreciate the comment, and intend to incorporate appeals
				information along with other relevant information in supporting
				materials on healthcare.gov. | 
		
			| 
				One
				commenter asked that we remove the request for an individual’s
				employer identification number (EIN), which is included in the
				applications for the exemptions for individuals who are unable to
				afford coverage. The commenter also asked that we revise the
				questions regarding the minimum value and cost of
				employer-sponsored coverage, that we revise the question
				regarding expected changes in an employer’s offerings and
				that we rename the employer coverage tool. | 
				EIN
				is used by the Marketplace to verify access to employer-sponsored
				coverage. Consistent with the electronic application for
				enrollment in a qualified health plan through the Marketplace and
				insurance affordability programs, we have added language to the
				applications that clearly notes that EIN is optional. The
				questions regarding minimum value, the cost of employer-sponsored
				coverage, and changes in employer offerings are based on what is
				used in the single, streamlined application for enrollment in a
				qualified health plan through the Marketplace and insurance
				affordability programs, and as such, we will be maintaining them
				for consistency. This is also the case for the name of the
				employer coverage tool. As with all of our applications, as we
				gain experience with the process, we will make appropriate
				modifications to enhance the consumer experience. | 
		
			| 
				One
				commenter asked whether an employer could be an authorized
				representative for an individual who is seeking an exemption. | 
				Nothing
				precludes an employer from serving as an authorized
				representative, provided that the standards specified in 45 CFR
				155.225 are met. | 
		
			| 
				One
				commenter asked that we remove the questions regarding foster
				care and incarceration from the application for the exemption for
				individuals who lack affordable coverage in states in which there
				is a Federally-facilitated Marketplace. | 
				The
				foster care question is included for use in determining whether
				an individual who is applying for this exemption is eligible for
				advance payments of the premium tax credit, which is necessary to
				calculate the cost of the lowest-cost bronze plan. If an
				individual is eligible for Medicaid, including as a result of
				former status as a foster child, he or she will be ineligible for
				advance payments of the premium tax credit, which will affect the
				cost of the lowest-cost bronze plan. Similarly, the question
				regarding incarceration is needed to determine whether an
				applicant is eligible for enrollment in a qualified health plan.
				Accordingly, we are maintaining these questions. We have,
				however, updated the incarceration question to be consistent with
				the single, streamlined application for enrollment in a qualified
				health plan and insurance affordability programs. | 
		
			| 
				One
				commenter asked that we clarify at the top of the application
				whether a consumer should use a hardship exemption form instead
				of an affordability exemption form. 
 | 
				We
				are making changes to make the hardship criteria more prominent.
				By making the hardship criteria more prominent, we believe that
				individuals will be clearer on which form to use. In addition, we
				anticipate providing educational information on healthcare.gov. | 
		
			| 
				One
				commenter asked that we add language to the hardship application
				to specify that applicants have three years to request a hardship
				exemption. | 
				We
				agree that this is useful information, and intend to incorporate
				it in frequently-asked-questions or other guidance that is
				provided along with these applications. | 
		
			| 
				One
				commenter asked that we eliminate the reference to catastrophic
				coverage in the hardship exemption application. | 
				We
				are maintaining this information in order to fully inform
				applicants of their potential eligibility for catastrophic plans
				after receiving a hardship exemption through the Marketplace. | 
		
			| 
				One
				commenter asked that we add language to the first page of all
				applications to explain that if the Marketplace needs more
				information, it will notify the applicant. | 
				We
				have added this language to the applications. | 
		
			| 
				One
				commenter asked that we delete the question from the hardship
				exemption application that asks whether an applicant is still
				experiencing the hardship, as well as the request for
				documentation. | 
				We
				have clarified that the question regarding whether the hardship
				is still in effect is only needed if the applicant does not
				provide an end date. This information is needed to define the
				duration of the exemption. The request for documentation is
				needed to ensure that the consumer submits the documentation
				described in table A in support of his or her application. | 
		
			| 
				One
				commenter asked that we change the column width in table A of the
				hardship exemption application, move the appendix to be the
				second page of the application, and add #13 for “Other”. | 
				We
				are modifying the column width of the table and moving it to be
				the second page, in accordance with the comment. Consistent with
				guidance, we are adding one category to the hardship application,
				for an individual who received a notice saying that his or
				existing health insurance is being cancelled, and who considers
				available plans unaffordable. We have also modified the table to
				include “Other” as an option. | 
		
			| 
				One
				commenter asked that we explain the procedure for individuals who
				are applying for a hardship exemption and do not have required
				documentation. | 
				We
				expect to disseminate these procedures through supplementary
				guidance and through contact with the call center. Accordingly,
				we have added language to the hardship exemption application that
				instructs applicants who cannot obtain the specified
				documentation to call the call center. | 
		
			| 
				One
				commenter asked that we specify that an applicant can document a
				fire, flood, or other natural or human-caused disaster that
				caused substantial damage to his or her property via a news
				report. | 
				We
				have added this to the hardship exemption application. | 
		
			| 
				One
				commenter asked that we develop an electronic method to obtain
				proof of a Medicaid or CHIP denial from the applicable state
				agency for the purpose of administering the hardship exemption
				related to children for whom an adult who is not claiming the
				child as a tax dependent is legally required to provide health
				insurance, instead of requesting proof of the denial from an
				applicant. | 
				We
				support the commenter’s recommendation for electronic
				verification. Unfortunately, there is currently no electronic
				method through which HHS can obtain information regarding denials
				that are not associated with an application submitted to the FFM.
				We will consider this in the future. | 
		
			| 
				One
				commenter asked that we not request documentation to substantiate
				an application for a hardship exemption based on a denial of
				eligibility for Medicaid because the applicant’s state did
				not expand Medicaid. | 
				Without
				proof of denial based on non-expansion, HHS will be unable to
				assess whether the individual actually applied for Medicaid, and
				whether or not he or she met the financial or non-financial
				eligibility criteria for Medicaid, since HHS is not conducting an
				eligibility determination as part of the hardship exemption
				process. We note that the Federally-facilitated Marketplace
				already provides this exemption in an automated fashion as part
				of the eligibility process for insurance affordability programs
				for individuals who submit an application to the FFM. | 
		
			| 
				Commenters
				asked that we eliminate language on the first page of the
				application for the exemption for members of recognized religious
				sects and divisions that paraphrases the language of the Internal
				Revenue Code regarding conscientious opposition to acceptance of
				the benefits of private or public insurance, including Medicare
				or Social Security. | 
				We
				have modified the language to more closely track the legislative
				language and ensure that the range of individuals who are
				eligible for this exemption is clear. | 
		
			| 
				One
				commenter asked that we include a list of the religious sects and
				divisions whose members qualify for the exemption for members of
				recognized religious sects and divisions. | 
				The
				list of approved religious sects is maintained by the Social
				Security Administration, and as such HHS does not have the
				authority to provide it to the public on its own. | 
		
			| 
				One
				commenter asked why an applicant for the exemption for members of
				recognized religious sects and divisions would be asked when they
				became a member of a sect and when membership ended. | 
				In
				accordance with 45 CFR subpart G, this exemption is generally
				provided on an ongoing basis, with the exception being any time
				period during which the individual was not a member of a
				recognized religious sect or division. These questions are
				designed to allow those individuals who gained or ended
				membership to provide that information, so that the Marketplace
				will provide the exemption certificate for only the actual time
				period of membership. Further, an applicant who has always been a
				member and plans to always be a member can skip these questions. | 
		
			| 
				One
				commenter asked that we add language to the application for the
				exemption for members of recognized religious sects and divisions
				to indicate that the approved list of organizations is maintained
				by the Social Security Administration. | 
				We
				have added this language. | 
		
			| 
				One
				commenter asked that we use a more common name for IRS Form 4029
				on the application for the exemption for members of recognized
				religious sects and divisions. | 
				The
				application includes the common name, “Application for
				Exemption from Social Security and Medicare Taxes and Waiver of
				Benefits” on the front page, which we believe is
				sufficient. |