A completed “Employer Coverage Tool” (this is optional and only applies if anyone in your household has or is eligible for coverage through their employer)
You should fill out an “Employer Coverage Tool” for each member of your family who’s eligible for a job-based plan, even if that person isn’t enrolled in the job based plan or isn’t applying for Marketplace coverage. You can get this information from your employer. This optional tool helps you gather information you may need for your application in one spot.
To get a copy of this form, visit HealthCare.gov/downloads/employer-coverage-tool.pdf. Your employer can help you fill this out.