Verification and Documentation Requirements Flashcards
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Read the first 7 Verification and Documentation Requirements flashcards as text
What type of income documentation is required for an applicant who receives Social Security benefits?
Answer: An SSA benefit verification letter (award letter) or SSA-1099
An SSA benefit verification letter (award letter) or the annual SSA-1099 form is the standard documentation used to verify Social Security income for Marketplace applications.
How does the Marketplace treat verification for American Indians and Alaska Natives (AI/ANs) who are exempt from the individual shared responsibility payment?
Answer: They must submit a tribal enrollment certificate to access zero cost-sharing plans
American Indians and Alaska Natives who wish to access zero cost-sharing Marketplace plans typically need to submit a tribal enrollment certificate or other documentation confirming membership in a federally recognized tribe.
When an applicant reports a change in household size (e.g., birth of a child), what documentation is typically required to verify this change?
Answer: A birth certificate or adoption decree
A birth certificate or adoption decree is the standard document required to verify a change in household size due to a new dependent, as these are official legal records of the life event.
An applicant claims they are exempt from the employer-sponsored insurance (ESI) offer because it is unaffordable. What documentation may the Marketplace request to verify this?
Answer: An employer verification form (such as Form 14950) or documentation of the lowest-cost self-only premium offered
The Marketplace may request an employer verification form (e.g., Form 14950) or other documentation showing the lowest-cost self-only premium offered by the employer to determine whether the ESI offer meets the affordability threshold.
What is the Marketplace's policy for verifying residency for applicants experiencing homelessness?
Answer: Self-attestation of state residency is generally accepted; a shelter or service provider address may be used
Applicants experiencing homelessness may self-attest to residency in a state and may use the address of a shelter, service provider, or other contact address, consistent with Marketplace rules designed to ensure access for vulnerable populations.
Which verification scenario requires the Marketplace to check DHS immigration records through the Federal Data Services Hub?
Answer: A lawfully present non-citizen claiming eligibility based on immigration status
For non-citizens claiming lawful presence, the Marketplace queries DHS records via the Federal Data Services Hub to electronically verify the immigration status information provided on the application.
If an applicant provides income documentation that conflicts with IRS data retrieved by the Marketplace, what is the CORRECT procedure?
Answer: The Marketplace notifies the applicant of the inconsistency and allows them to submit documentation explaining the difference
When applicant-provided income conflicts with IRS data, the Marketplace follows a notice-and-opportunity process, giving the applicant a chance to explain the discrepancy with supporting documentation before making a final eligibility determination.