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Marketplace Special Enrollment Qualification -A special enrollment period generally lasts 30-60 days before or after the qualifying event

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1.First and Last Name
2.Phone & Email Address
3.Do you currently have health insurance, or not?
4.Have you loss qualified health coverage within the last 60 days?
5.Who pays for your health insurance? (Check all that apply)
6.Why do you currently not have health insurance? (Check all that apply)
7.What is your Life Changing Event to Qualify of Special Enrollment?
Current Progress,
0 of 7 answered