CEC Verification and Documentation Requirements

Question 1

When the Marketplace finds a data inconsistency related to an applicant's income, what is the FIRST action taken?

Accepted Answer

The applicant is notified and given an opportunity to resolve the inconsistency

Answer

The application is immediately denied

Answer

The case is referred to the IRS for investigation

Answer

Enrollment is suspended pending a federal audit

Question 2

How long does a Marketplace applicant typically have to submit documentation to resolve a data inconsistency after receiving notice?

Accepted Answer

90 days

Answer

15 days

Answer

30 days

Answer

60 days

Question 3

Which federal agency's records does the Marketplace primarily use to verify Social Security numbers?

Accepted Answer

Social Security Administration (SSA)

Answer

Department of Homeland Security (DHS)

Answer

Internal Revenue Service (IRS)

Answer

Centers for Medicare & Medicaid Services (CMS)

Question 4

Which document is MOST commonly used to verify current wages from an employer during a Marketplace application?

Accepted Answer

Recent pay stubs from the past 30 days

Answer

Prior-year federal tax return (Form 1040)

Answer

A letter from a doctor confirming employment

Answer

Form W-9 from the employer

Question 5

What happens to an enrollee's Marketplace coverage if they fail to resolve an income inconsistency within the required timeframe?

Accepted Answer

Their eligibility is redetermined based on the data sources the Marketplace has on file

Answer

Their coverage is immediately terminated

Answer

Their premium tax credit is reduced to zero permanently

Answer

They are enrolled in Medicaid automatically

Question 6

Which document is an acceptable proof of U.S. citizenship for Marketplace enrollment?

Accepted Answer

U.S. passport or U.S. birth certificate

Answer

State-issued driver's license

Answer

Permanent Resident Card (Green Card)

Answer

Employment Authorization Document (EAD)

Question 7

What is the primary method the federally facilitated Marketplace (FFM) uses to verify applicant information at the time of application?

Accepted Answer

Electronic data matching through the Federal Data Services Hub

Answer

Manual review of paper documents submitted by applicants

Answer

In-person interviews at local Social Security offices

Answer

Phone verification with the applicant's employer