21229 HILLSIDE AVE
QUEENS VLG, NY 11427-1803
December 1, 2013
Account ID: AC0000372177
Dear Beauvoir Regis,
Welcome to the New York Marketplace.
This letter confirms that you have chosen to receive all information from the New York
Marketplace electronically. This means that all important notifications will be sent to your
Marketplace account. We will notify you of any new information via text message, email, or other electronic communication. We will not include any confidential information in the email or electronic alert. You can also request any notice posted to your account to be sent via regular mail.
If you need help accessing your user account log-in or password, please contact
1-855-355-5777.
If this is not accurate, please contact 1-855-355-5777.
It is important for you to let us know if your contact information such as the mailing address, email address, and telephone number (including cell phone) changes. To let us know of any changes, please contact the Marketplace.
You have the right to change this selection, at any time, to receive all notices and updates through regular paper mail. If you want to change this selection, contact the Marketplace.
How to Contact the New York Marketplace
Contact us if you have any questions about this letter. Let us know if you need help applying for or accessing your health insurance. You can contact us in any of the following ways: • Online at https://www.nystateofhealth.ny.gov;
• By calling 1-855-355-5777 (TTY: 1-800-662-1220);
If you need this information in a language other than English, or you need assistance reading this letter we can help you. Call 1-855-355-5777 (TTY: 1-800-662-1220).
N031
• By mail at:
New York Marketplace
PO Box 11727
Albany, New York 12211
Sincerely,
New York Marketplace
Legal Reference
We are sending you this notice in accordance with Federal regulation 45 CFR §
155.230(d).
2 of 2
N031