Health Insurance Marketplace Statement Form Template

Available on the Free Plan

Simplify record keeping and make tax time easier with this health insurance marketplace statement that you can copy and customize with our form builder. No tech skills necessary! Need HIPAA? You can cover it with our HIPAA-compliant form builder that is available on a 123FormBuilder Enterprise subscription plan.

Customize template

While this health insurance marketplace statement template includes the basic data points required to generate annual statements, you can adapt the form as necessary. For example, use your choice of radio buttons, text fields, dates and many more. Then configure it to send a copy to key individuals in your accounting and payroll department.

Publish template

There are many convenient ways to share this health insurance marketplace statement generator with your team. Just copy the embed snippet to add to a page on the web or your intranet, or just click a button to email a direct link to the form. Of course, its mobile-friendly layout is great for people on the go!

Collect & manage data

All submissions to the health insurance marketplace form template are compiled in a secure database accessible through your 123FormBuilder dashboard. There you can generate charts and graphs of health insurance coverage data or export the records into Excel, CSV or PDF. In addition, be sure to explore options for integrations that transfer form data directly into third-party apps.

Optimize processes

Streamline the process of generating health insurance marketplace statements with an easy online form that decreases paperwork and enhances privacy. With collaborative features like real-time notifications and multi-user access, old barriers to communication will disappear before your eyes. Plus, the real-time notifications will keep you aware of each new form submission.

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