Agents and brokers play a vital role in helping consumers understand data matching issues (DMIs) and submit documents or update their application to resolve their issues. DMIs are caused when information on a consumer’s application does not match the Centers for Medicare & Medicaid Services (CMS) trusted data sources or CMS does not have available data for a consumer.
Now is a critical time in the DMI process for consumers with open issues on their Plan Year 2022 applications because:
- Large numbers of consumers are running out of time to submit documents to resolve their data matching issues.
- Consumers who do not resolve their issues will lose advance payments of the premium tax credit (APTC) or coverage.
- Agents/Brokers will lose commissions for many of these consumers if documents are not submitted and issues are not resolved.
- Check consumer accounts NOW and have consumers submit any needed documents
Common Causes of DMI Expirations (when a DMI is not resolved):
- The consumer did not submit any supporting documentation.
- The type of documentation submitted is not on the list of approved documents for the consumer’s specific DMI. Frequent issues include:
- Income documentation that is more than two years old.
- Submitting a Social Security number (SSN) card to resolve a citizenship DMI. You should submit a passport or other acceptable document from the list, since an SSN card will not resolve a citizenship issue on its own.
- The documentation submitted does not have enough information to resolve the data inconsistency, such as only submitting income information for the applicant’s job but no information for their spouse’s job.
- The documentation submitted has errors, such as the name on the application is different than on the submitted document.
- The documents submitted are not in the proper format (they must be .pdf, .jpeg, .jpg, .gif, .xml, .png, .tiff, or .bmp, and no larger than 10 megabytes).
- The information provided on the consumer’s application was incorrect.
To learn more about helping consumers resolve DMIs, please view the webinar deck “Helping Consumers Resolve DMIs” available on REGTAP. Additionally, check out the resources below.
- Agent/Broker Video Learning Center: How to Resolve a Marketplace DMI
- Agent/Broker Frequently Asked Questions
- Webinar Slides: How to Resolve Income DMIs
- gov: How to Upload Documents
- gov: How do I resolve a DMI?
- gov: Guide to Confirming Your Income Information
- gov: DMI Blog Post
Contact your Cornerstone representative with any questions.