Both employers and employees of small businesses can appeal decisions by the SHOP Marketplace.

SHOP Marketplace decisions you can appeal

Employers and employees can appeal 2 kinds of SHOP Marketplace actions:

  • Denial of eligibility for the SHOP Marketplace
  • SHOP Marketplace not making an eligibility determination in a timely manner

If you're not eligible to participate in the SHOP Marketplace, you'll get a notice with details specific to your situation. You have 90 days from the date of the notice to request an appeal.

If you state is running its own SHOP Marketplace, the appeals process may be different. Refer to your state's SHOP Marketplace for more details.

How to file a SHOP appeal

Your SHOP eligibility determination notice will explain how to file an appeal for your specific situation.

You can appeal by filling out one of the forms below.

Mail your completed appeals form to:

SHOP Marketplace Appeals
Health Insurance Marketplace
465 Industrial Blvd.
London, KY 40750-0001

An authorized representative can file an appeal for you. You may also get help in a language other than English.

Note: Keep a copy of your appeals form for your records.

After you file an appeal

You’ll get a letter or phone call saying that your appeal was received. It will provide a description of the appeals process and instructions for submitting additional materials if needed.