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Qualifying for Secondary Principal Business or Headquarters Address

As a result of a recent update effective January 1, 2017 to the Patient Protection and Affordable Care Act, groups with the greatest number of their eligible W-2 employees living outside the employer's local service area may be able to use a secondary address for plan selection. Please answer the questions in this questionnaire to determine if your group qualifies to use a secondary address as their principal business address for plan selections. Once completed, please include with your case submission.

Principal Business or Headquarters Address Questionnaire (PDF)