Refer to Section 112.363,. Fill in the rows starting with Name, Residence and Mailing Address.Please print your information. Gov to apply online. We need at least your name, address, and a signature. Processing begins the daywe receiveyour signed application. To apply for or re-enroll in your Marketplace coverage, visit HealthCare. Gov or call the Marketplace Call Center at. 1-800-318-2596. Filling out this application doesn't mean you have to buy health coverage. Get help with this application.