When a Data Matching Issue is not resolved your client may lose their subsidy or health coverage. That’s why it’s important to understand the different types of DMIs, why they occur, and how to easily resolve them from your HealthSherpa dashboard.

A Data Matching Issue (DMI) occurs in the following situations:

  • Incorrect or missing information on the client’s application (e.g. missing SSN or household information)

  • An inconsistency between the client’s Marketplace application and existing information from trusted sources (e.g. IRS database, DHS, SSA)

  • A trusted data source may not have data for a consumer

Clients have 90-95 days to resolve a DMI based on the date their application was submitted (not the effective date).

Here is a list of all Data Matching Issues (the first three are the most common):

  • Citizenship

  • Household income

  • Immigration status

  • Incarceration status

  • American Indian or Alaska Native status

  • No minimum essential job-based coverage

  • No coverage through: Medicaid or the Children’s Health Insurance Program (CHIP)

  • No coverage through: TRICARE

  • No coverage through: Veterans Health Care Program

  • No coverage through: Medicare

  • No coverage through: Peace Corps

  • Social Security Number

Missing Social Security Number

The most common Data Matching Issue is caused by a missing Social Security Number on an application.

Although a Social Security Number may be listed as “optional” on the app it is actually required for both the primary applicant and all dependents unless someone does not have one (eg. an immigrant or newborn baby). When an SSN is missing, an income, immigration or citizenship DMI may be generated.

Typically, the quickest way to resolve this type of DMI is to resubmit the app with an SSN by reporting a life change. Here’s how:

  • Head over to the “Clients" tab inside your dashboard

  • Use the “Documents” filter to see current status

  • Filter by “Action Needed” and “Insufficient Documents”

  • Click on the "View" button on the right-hand side of a client’s name

  • Select "Report changes" and then click on the "Update" button

  • Add an SSN for everyone listed on the application including all dependents

  • Confirm that each name (for both primary and dependents) match their SSN cards

  • If a dependent doesn’t have an SSN, check the box indicating that they don’t have one

  • Continue through the rest of the app and resubmit

Follow-Up Documents

In order to resolve other DMIs you likely will need to upload follow-up documents to verify information on the application. Here’s how:

  • Head over to the “Clients" tab

  • Use the “Documents” filter to see current status

  • Filter by “Action Needed” and “Insufficient Documents”

  • Click the "View" button on the right-hand side of each client

  • Review all follow-up items and click the “Verify” button

  • Upload any required documents

After you click on the “Verify” button, that page also includes a list of acceptable documents that you can upload to resolve a Data Matching Issue. This list varies based on the type of DMI.

Here are a few examples:

  • U.S. Passport

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

  • Permanent Resident Card, "Green Card" (I-551)

  • 1040 Federal or State Tax Return

  • Wages and Tax Statement (W-2/1099)

  • Self-Employment Documentation

  • Bookkeeping records

If you have any additional questions please contact our Agent Support Team at 888-684-1373 or by email at agent_support@healthsherpa.com.

Otherwise, log into your HealthSherpa account to start resolving DMIs today.

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