CACs Verification and Documentation Requirements 1 — Questions and Answers
Question 1: Which document is most commonly used to verify U.S. citizenship for a Marketplace health insurance application?
- State-issued driver's license
- U.S. passport or birth certificate (Correct answer)
- Employer identification badge
- Social Security card alone
Correct answer: U.S. passport or birth certificate
A U.S. passport or birth certificate are primary documents used to verify citizenship status for Marketplace enrollment purposes.
Question 2: Which income document is typically acceptable for verifying annual income for a salaried employee applying for Marketplace coverage?
- Personal bank statements from the past 12 months
- A signed letter from a neighbor confirming employment
- Most recent W-2 form or recent pay stubs (Correct answer)
- Utility bills showing the applicant's address
Correct answer: Most recent W-2 form or recent pay stubs
A W-2 form or recent pay stubs are standard IRS-recognized documents used to verify wage income for Marketplace applications.
Question 3: How long does an applicant typically have to resolve a data matching issue (inconsistency) after receiving a notice from the Marketplace?
- 15 days
- 30 days
- 90 days (Correct answer)
- 180 days
Correct answer: 90 days
The Marketplace generally provides applicants 90 days to submit documentation resolving a data matching issue before coverage or financial assistance may be terminated.
Question 4: What is the primary electronic resource the Marketplace uses to verify an applicant's income during the application process?
- State Department of Motor Vehicles database
- Federal Data Services Hub connecting to IRS and SSA records (Correct answer)
- Employer payroll systems accessed directly
- Consumer credit bureau reports
Correct answer: Federal Data Services Hub connecting to IRS and SSA records
The Federal Data Services Hub connects the Marketplace to IRS, Social Security Administration, and other federal databases to electronically verify income and other eligibility data.
Question 5: Which of the following documents can verify an applicant's Social Security Number (SSN) for Marketplace enrollment?
- Voter registration card
- Social Security card or SSA-issued letter showing the SSN (Correct answer)
- Library card with a photo
- Utility bill with the applicant's name
Correct answer: Social Security card or SSA-issued letter showing the SSN
A Social Security card or an official letter from the Social Security Administration displaying the SSN is the recognized form of SSN verification.
Question 6: What happens if an applicant fails to verify their immigration status within the required 90-day period after receiving a data matching notice?
- The applicant automatically qualifies for Medicaid instead
- The applicant's enrollment and any APTC may be terminated until resolved (Correct answer)
- The Marketplace extends the deadline automatically by another 90 days
- The applicant is referred to ICE for investigation
Correct answer: The applicant's enrollment and any APTC may be terminated until resolved
If an immigration status inconsistency is not resolved within 90 days, the Marketplace may terminate the applicant's enrollment and any advance premium tax credits.
Question 7: What is a 'data matching issue' in the context of a Marketplace enrollment application?
- When an applicant applies to more than one state Marketplace simultaneously
- When information submitted by the applicant does not match data found in federal or state databases (Correct answer)
- When a CAC enters incorrect contact information for a consumer
- When two family members apply for different types of coverage
Correct answer: When information submitted by the applicant does not match data found in federal or state databases
A data matching issue (inconsistency) occurs when the information an applicant provides on their application conflicts with information returned from verification data sources such as the IRS or SSA.
