Income Verification by Health Insurance Marketplaces

According to an FAQ on the CCIIO website, HHS has clarified that, for the federally-facilitated marketplaces, CMS intends to verify the income on 100% of the applications for advance payment of the premium assistance credit and cost-sharing reductions. The marketplaces will first try and verify the information electronically using available data from IRS, SSA, and Equifax. If the data on the application cannot be verified, the marketplace will request an explanation or additional documentation from the applicant to substantiate the income. For 2014, a state-based marketplace may choose to verify the income of a statistically significant sample size that is less than 100%, for applicants that meet certain requirements.


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