FFM News Alert for Agents/Brokers – Eligibility Determination Notices with Data Matching Issues

Please be advised of the following, related to Eligibility Determination Notices with Data Matching Issues Carried Over from 2014:

• Consumers who are still working with the Marketplace to resolve a 2014 data matching issue, and who return to the Marketplace for 2015 open enrollment to update their application and select the same plan or a new plan for 2015 may receive a new 2015 eligibility determination notice with a past due date for resolving a data matching issue(s). 
• For example, a consumer applied last year on March 20, 2014 and generated a citizenship data matching issue on their application. The consumer submitted some documentation to the Marketplace over the summer, and is still working with the Marketplace to resolve the issue. The same consumer returns to the Marketplace on November 20, 2014 and updates their application for open enrollment for 2015.  This consumer may, due to a system issue, receive a new 2015 eligibility determination notice informing the consumer that they have until June 18, 2014 to resolve their citizenship data matching issue.  (This scenario will apply most prominently to consumers with issues related to citizenship, immigration and incarceration.)

Please note:

• Consumers who are citizens -- and/or have lawfully present permanent status -- that received notice from the Marketplace that their data matching issues in 2014 were resolved should not have to submit any further documentation to the Marketplace. 
• However, due to a systems issue, some consumers may get a new eligibility determination notice with a past due date for resolving their citizenship data matching issue when they return to the Marketplace for open enrollment for 2015. These consumers do not need to submit documentation again to the Marketplace.  These consumers are at no risk of losing coverage in 2015 based on citizenship.
• Consumers who did not previously receive a notice from the Marketplace that their data matching issue was resolved and who return to the Marketplace for open enrollment for 2015 will get a new eligibility determination notice with a past due date for resolving their data matching issue.  These consumers should, as soon as possible, submit documentation to the Marketplace to ensure that 2014 coverage can be maintained and 2015 coverage can be provided.

Consumers that return to the Marketplace for open enrollment for 2015 and have annual income data matching issues should not receive an eligibility determination notice with a past due date for resolution.  Annual income is verified each year, so consumers with annual income data matching issues should submit documentation in support of their 2015 household income attestation to the Marketplace.