Application for Exemption from the Shared Responsibility Payment for Individuals who Experience Hardships

Download

Here is the application to use to apply for an exemption from the shared responsibility payment.

Intended audiences: Assisters / Navigators
Topics: Affordable Care Act, Assister / Navigator Tools, Financial Assistance, Tax Education, Enrollment, Premium Tax Credits & Cost Sharing Reductions
Tags: Hardship

« Back to browsing

Share this page

Disclaimer: Illinois Health Resources is not responsible for the availability or content of external nonfederal Web sites that link to the Resource Repository section of its Web site, nor do we endorse, warrant, or guarantee the services or information described or offered on external nonfederal Web sites. The views and information provided on external nonfederal Web sites do not necessarily state or reflect those of Illinois Health Resources or the U.S. Department of Health and Human Services.