State of Maryland Health Insurance Exchange Person ID

Les résumés et les traductions contenus dans le présent avis ont été préparés par Primary Care Coalition mais n'ont pas été révisés ou approuvés
par Maryland Health Connection.
State of Maryland
Health Insurance Exchange
Notice Date: 06/16/2015
Type Plan
123 Main Street
Edgewater, MD 21037
Person ID: 1111557318
Doc ID: 61016
Application Date: 06/16/2015
La présente lettre vous informe que vous avez entamé la
procédure de souscription à une assurance maladie, mais
ne l'avez pas achevée. Elle vous rappelle d'achever le
processus et de soumettre votre demande en vous
connectant sur votre compte à l'adresse
www.MarylandHealthConnection.gov
Application ID: 32198
Subject – Enrollment Application in Progress
Dear Type Plan,
Our records show that you recently started an enrollment application for a health insurance coverage on
Maryland Health Connection for yourself or a member of your household. We would like to remind you that you
must complete and submit your application for enrollment before 08/15/2015 in order to enroll during your
available enrollment period.
Please return to Maryland Health Connection's website before this date to complete and submit your
application. If you do not complete and submit your application for enrollment before 08/15/2015, you may not
be able to enroll in a health insurance plan until the next annual open enrollment period. Your saved
application can be accessed through the Account Home section of the Maryland Health Connection website at
www.marylandhealthconnection.gov. You can also apply in other ways by contacting Maryland Health
Connection in one of the ways set out below.
How to Contact Maryland Health Connection
Contact Maryland Health Connection if you need to report changes, select a program or have any questions
about this notice. Let us know if you need help applying for health coverage or accessing your account. You
can contact Maryland Health Connection:
• Online at www.marylandhealthconnection.gov
• By calling 1-855-642-8572 and TTY: 1-855-642-8573
• In person at your local Health Department, local Department of Social Services or regional Connector
Entity
If you have a disability, you may request and receive a reasonable accommodation or special help from
Maryland Health Connection when it is necessary to allow you to apply for and receive services through
Maryland Health Connection.
Sincerely,
Maryland Health Connection
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State of Maryland
Health Insurance Exchange
Person ID: 1111557318
Doc ID: 61016
Language services are available to assist you. If you need assistance, call 1-855-642-8572 (TTY:
1-855-642-8573). Servicios de idiomas están disponibles para ayudarle. Si necesita ayuda, llame al
1-855-642-8572 (TTY: 1-855-642-8573)
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