This post was originally published by Healthcare.gov.
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.
Large numbers of consumers are running out of time to submit documents to resolve their DMIs and consumers who do not resolve their issues will lose advance payments of the premium tax credit (APTC) or coverage. Agents and brokers should check consumer accounts NOW and have consumers submit any needed documents.
Common causes of DMI expirations (when a DMI is not resolved) include:
- 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 card to resolve a citizenship DMI. You should submit a passport or other acceptable document from the list, since a Social Security 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, you can review a recent CMS webinar deck on this topic, Submit Acceptable Documents to Resolve DMIs. Additionally, check out these resources:
- Agent/Broker Video Learning Center: How to Resolve a Marketplace DMI
- Agent/Broker Frequently Asked Questions