18.207.240.77
*Open Enrollment for Marketplace coverage is closed but you can enroll or change plans if you have certain life events or income change:
- Low-Income Special Enrollment Period for people with an income between 100-150% of the Federal Poverty Level (FPL).
- Involuntary Loss of Employer (Cobra) or Public (Medicare/Medicaid) Insurance Coverage.
- Gained Eligible Immigration Status.
- Released from incarceration.
- Change in household size because of marriage, divorce, adoption, dependent removed, legal separation, etc.
- Change in Residence/Moved to a New Zip Code. (Must have had active insurance for at least 1 day in the 60 days prior to the move)
- Recently denied Medicaid or CHIP Coverage
»Click here to find out if you can enroll/change plans.
** If you live in Miami-Dade County there is a different enrollment process **
For the required enrollment process contact your case manager.
I have NOT enrolled in a Federally Facilitated Marketplace Plan for 2023:
**Do not complete this form if you have already completed an enrollment in a Federally Facilitated Marketplace Health Insurance Plan for 2023 through the Federally Facilitated Marketplace or through an Agent/Broker.
Only complete this form if you need assistance with Federally Facilitated Marketplace enrollment from BRHPC/American Exchange.
American Exchange is a CMS Certified Federally Facilitated Marketplace Agent/Broker in the State of Florida and will act as your Agent of Record upon completing this form.**
Click Here »
If you need assistance completing
this form call 1-844-441-4422
I have Already enrolled in an Insurance Plan for 2020:
Complete this form if you have already enrolled in a Federally Facilitated Marketplace Plan for 2020 and want to keep your current Agent/Broker.
You will have to rely on your current Agent/Broker for customer service and any premium payment issues.
**Please only complete this form if you have already successfully enrolled in a Federally Facilitated Marketplace Plan for 2020.**
Click Here »
If you need assistance completing
this form call 1-844-441-4422
I have NOT enrolled in an Insurance Plan for 2020:
The option to enroll through this site is no longer available. If you have not enrolled, you have until 3:00 AM eastern time (EST) in order to complete your enrollment. Please go to
https://www.healthcare.gov/ to complete your enrollment.
You may qualify for a Special Enrollment Period (SEP) if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child. If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan.
Click Here »
If you need assistance completing
this form call 1-844-441-4422
I have Already enrolled in an Insurance Plan for 2020:
Complete this form if you have already enrolled in a Federally Facilitated Marketplace Plan, Employer Sponsored Plan or COBRA for 2020.
**Please only complete this form if you have already successfully enrolled in a Federally Facilitated Marketplace Plan for 2020.**
Click Here »
If you need assistance completing
this form call 1-844-441-4422
Program Enrollment Assistance:
1-844-441-4422
Eligibility Assistance:
1-844-381-2327
*Insurance Enrollment Assistance is provided by our partner American Exchange
** If you live in Miami-Dade County there is a different enrollment process **
For the required enrollment process contact your case manager.
» How to Read an Insurance ID Card and Information on Doctors, Pharmacies & Hospitals:
Click Here »
» Examples of "Explanation of Benefits (EOB)" & "Health Insurance Bill":
Click Here »
» Information regarding Medicare and Enrollment:
Click Here »
» Insurance Enrollment Outreach, Education and Technical Assistance Educational Materials:
Click Here »
» Assistance with understanding the “Explanation of Benefits”:Click Here »
» Assistance with understanding the “Explanation of Benefits”:Click Here »
» Premium Assistance Internal Client Complaint Procedure Grievance Process:
Complete the required sections on the form and mail or fax
to the responsible party as noted on Page 6 of the document.
Click Here to download form