Federally-Facilitated Marketplace (Ffm) User Fee Adjustment Web Form Quick Startguide - Centers For Medicare And Medicaid Services Page 17

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FFM User Fee Adjustment Web Form Quick Start Guide
Step
Action
3
Complete the Attester Details section with the following information:
•
First Name
•
Last Name
•
Email Address
•
Job Title
•
Phone Number
•
Phone Extension (optional)
Reminder:
The individual providing the attestation must be someone
who can legally and financially bind the company. This individual does
not have to personally complete these steps. This person is not
required to be the Submitter or Alternate Contact.
4
Select the Submit button.
By selecting the Submit button on the Attestation page, your
data is saved, and your attestation and FFM User Fee Adjustment
information are submitted and deemed complete by CMS.
FFM User Fee Adjustment Web Form Quick Start Guide
17

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