CEC Verification and Documentation Requirements 3

Question 1

What type of income documentation is required for an applicant who receives Social Security benefits?

Accepted Answer

An SSA benefit verification letter (award letter) or SSA-1099

Answer

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.

Question 2

How does the Marketplace treat verification for American Indians and Alaska Natives (AI/ANs) who are exempt from the individual shared responsibility payment?

Accepted Answer

They must submit a tribal enrollment certificate to access zero cost-sharing plans

Answer

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.

Question 3

When an applicant reports a change in household size (e.g., birth of a child), what documentation is typically required to verify this change?

Accepted Answer

A birth certificate or adoption decree

Answer

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.

Question 4

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?

Accepted Answer

An employer verification form (such as Form 14950) or documentation of the lowest-cost self-only premium offered

Answer

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.

Question 5

What is the Marketplace's policy for verifying residency for applicants experiencing homelessness?

Accepted Answer

Self-attestation of state residency is generally accepted; a shelter or service provider address may be used

Answer

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.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC Verification and Documentation Requirements 3