Federally-Facilitated Marketplace (Ffm) User Fee Adjustment Web Form Quick Startguide - Centers For Medicare And Medicaid Services Page 16

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FFM User Fee Adjustment Web Form Quick Start Guide
Figure14: Summary Page – TPA/PBM (2)
5 Submitting an Attestation
5.1
Attestation
The individual providing the attestation must be someone with the
authority to legally and financially bind the company. This person is not
required to be the Submitter or Alternate Contact. This individual does
not have to personally complete these steps.
Table 7: Attestation
Step
Action
1
Thoroughly review the Attestation statement in its entirety.
2
Select the check box next to the Attestation statement to indicate
agreement.
FFM User Fee Adjustment Web Form Quick Start Guide
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