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Small Business Employee Benefits and HR Blog

Hundreds of Thousands Could Lose Premium Tax Credits

docuementationLast month, the Centers for Medicare and Medicaid Services (CMS) announced that over 300,000 individuals who received health insurance coverage through the Marketplace were at risk of having their coverage cancelled. Those individuals were given a deadline of September 5, 2014 to submit documentation to verify their citizenship. Now, approximately 297,000 households have income data-matching issues that need to be resolved by September 30, 2014, according to the latest news release by CMS.

Hundreds of Thousands with Income Data Matching Issues

Yesterday’s news release explained that the CMS is trying to resolve all data matching issues incurred during the first year by open enrollment (November 15, 2014). The intention is that any inconsistencies can be resolved by the time the re-enrollment process begins.

Any enrollees who do not respond to the numerous attempts to contact them by September 30, 2014 may see the costs of their healthcare coverage change, according to the CMS news release. Enrollees could see the cost of their monthly premium, out-of-pocket costs, and even their tax bill or refund amount change during filing season.

Although 297,000 households, or approximately 363,000 individuals, are at risk of losing their Marketplace coverage or seeing changes in their costs because of data matching issues, the number has been significantly reduced in the last three months. In fact, of the 1.2 million households with income data matching issues as of May 30, 2014, 879,000 households are now closed or in progress.

The remaining enrollees will receive letters from the CMS stating that if they do not send in the supporting documents by September 30th, the costs of their coverage will likely change.

Marketplace Enrollees with Citizenship Data Matching Issues

In August, the CMS sent letters to about 310,000 Marketplace Enrollees who had citizenship and immigration data matching issues. The CMS news release reported that out of the enrollees who had until September 5, 2014 to submit documentation verifying citizenship, 115,000 enrollees have not responded to numerous contact attempts.

These individuals will receive notices stating that their last day of Marketplace coverage is September 30, 2014. Enrollees who submit information confirming their citizenship after the deadline may be eligible for a special enrollment period.

How to Submit Documentation to Stay Covered Under the Marketplace

Individuals who have received these notifications should:

  • Review the eligibility reminder notice to verify the type of documentation needed

  • Log in to their Marketplace account to select their current application

  • Upload the corresponding documentation needed to correct each inconsistency in their application details

Acceptable Documentation to Confirm Income

To confirm income, the Marketplace will accept:

  • Tax return

  • W-2 form

  • Pay stub

  • Letter from employer

  • 1099 form

  • Bank statement

For a full list of acceptable documentation to confirm income, visit healthcare.gov.

Acceptable Documentation to Confirm Citizenship

To confirm citizenship, the Marketplace will accept one of the following:

  • U.S. passport

  • Certificate of Naturalization (N-550/N-570)

  • Certificate of Citizenship (N-560/N-561)

  • State-issued enhanced driver's license (available in Michigan, New York, Vermont, and Washington)

For a full list of acceptable documentation to confirm citizenship, visit healthcare.gov.

Read the news release at CMS

Photo Credit: jenni from the block

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