CACs Verification and Documentation Requirements 2 — Questions and Answers
Question 1: Which federal agency provides citizenship and immigration data to the Marketplace through the Federal Data Services Hub?
- Department of Defense (DoD)
- Department of Homeland Security (DHS) (Correct answer)
- Department of Agriculture (USDA)
- Department of Commerce (DOC)
Correct answer: Department of Homeland Security (DHS)
The Department of Homeland Security (DHS) provides immigration status and citizenship verification data to the Marketplace via the Federal Data Services Hub.
Question 2: A self-employed applicant applying for Marketplace coverage typically submits which document to verify their income?
- A recent W-2 form from their employer
- Most recent federal tax return (Schedule C) or a signed attestation with supporting records (Correct answer)
- A letter from a certified public accountant alone is sufficient
- Last three months of business invoices only
Correct answer: Most recent federal tax return (Schedule C) or a signed attestation with supporting records
Self-employed individuals typically verify income using their most recent federal tax return including Schedule C, along with supporting business records if needed.
Question 3: How long does an applicant who qualifies for a Special Enrollment Period (SEP) typically have to submit verification documents after enrolling?
- 7 days
- 15 days
- 30 days (Correct answer)
- 60 days
Correct answer: 30 days
SEP applicants generally have 30 days from the date of enrollment to submit acceptable verification documents confirming their qualifying life event.
Question 4: In Marketplace terminology, what does the term 'inconsistency' specifically refer to?
- A plan that changes its benefits mid-year
- A discrepancy between what an applicant attests on their application and what federal data sources return (Correct answer)
- A CAC who assists consumers in more than one county
- An applicant who switches plans during open enrollment
Correct answer: A discrepancy between what an applicant attests on their application and what federal data sources return
An 'inconsistency' in Marketplace terms is a discrepancy between applicant-attested information and the data retrieved from federal or state verification sources.
Question 5: Which of the following would NOT be an acceptable document for verifying the identity of a Marketplace applicant?
- State-issued driver's license
- U.S. military ID card
- A utility bill listing the applicant's name and address (Correct answer)
- U.S. passport
Correct answer: A utility bill listing the applicant's name and address
A utility bill shows residency but does not verify identity (i.e., it includes no photo and is not a government-issued ID), so it is not acceptable as an identity document.
Question 6: What is the primary purpose of the Federal Data Services Hub in the Marketplace verification process?
- To store copies of all paper applications submitted nationwide
- To provide a real-time connection between Marketplace systems and federal data sources for eligibility verification (Correct answer)
- To calculate premium tax credit amounts for each applicant
- To communicate directly with health insurance issuers about enrollment
Correct answer: To provide a real-time connection between Marketplace systems and federal data sources for eligibility verification
The Federal Data Services Hub acts as a central connector, allowing the Marketplace to query IRS, SSA, DHS, and other federal agencies in real time to verify applicant eligibility data.
Question 7: When an applicant reports having access to employer-sponsored insurance (ESI), what information is the Marketplace required to verify?
- The employer's annual revenue and number of employees
- Whether the ESI offer meets minimum value and affordability standards (Correct answer)
- The names and ages of all employees at the employer
- Whether the employer has ever been audited by the IRS
Correct answer: Whether the ESI offer meets minimum value and affordability standards
The Marketplace verifies whether an employer's health plan meets the minimum value standard (covering at least 60% of costs) and affordability threshold to determine APTC eligibility.
CACs Verification and Documentation Requirements 2
Which federal agency provides citizenship and immigration data to the Marketplace through the Federal Data Services Hub?