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The Federally Facilitated Marketplace (FFM) will only accept agent-assisted applications that include verifiable Social Security Numbers (SSNs) for all applicants over 90 days old.
Agents assisting non-U.S. citizens who do not have an SSN but do have qualifying immigration status can enter immigration document details instead. This applies to agent-assisted applications submitted on all enrollment platforms.
In this article we’ll cover:
Data verification
Frequently asked questions
Additional resources
SSN requirements at a glance
The Centers for Medicare & Medicaid Services (CMS) verifies Social Security Numbers (SSNs) and immigration documentation in real time during the application.
An agent-assisted application cannot move forward when:
An applicant over 90 days old does not have a verifiable SSN or immigration documentation
The SSN or immigration documentation provided is invalid
The SSN or immigration documentation provided does not match the applicant’s information
SSN and immigration documentation review is handled by CMS. HealthSherpa displays specific errors based on the CMS verification response.
Consumers who do not want to share their Social Security Number (SSN) or immigration documentation with their agent, or who do not have the information available, can complete their own consumer-driven application instead.
Consumer-driven applications may allow the consumer to submit without this information during the application, but this only delays the requirement. The SSN or immigration documentation will still need to be provided later. If the information is not provided or cannot be verified, a Data Matching Issue (DMI) may generate.
How SSN requirements appear in the application
Social Security Number (SSN) and immigration documentation requirements depend on whether each household member is applying for coverage. For non-applicants, this information is optional but recommended to help avoid Data Matching Issues (DMIs).
Primary applicant
Primary applicant
The primary contact on a consumer’s Marketplace application is typically the primary tax filer for the household or the spouse of the primary tax filer when married and filing jointly.
Primary contact is applying for coverage
Primary contact is applying for coverage
If the primary contact is applying for coverage, select Yes to the Are you applying for coverage question. The primary contact will also be the primary applicant.
When the primary contact is applying for coverage during an agent-assisted enrollment:
SSN is required for U.S. citizens who have been issued an SSN.
Non-U.S. citizens without an SSN can select I don’t have an SSN. Immigration documentation will be required on the following pages.
Primary applicant without an SSN
Primary applicant without an SSN
If I don’t have an SSN is selected for the primary applicant during an agent-assisted enrollment and the Members section later shows that the consumer is a U.S. citizen, an SSN Required message will appear. The application will not be able to proceed without an SSN for the primary applicant.
If I don’t have an SSN is selected for the primary applicant during an agent-assisted enrollment and the consumer is a non-U.S. citizen, immigration documentation information will be required in the Members section before the application can proceed.
Primary contact is not applying for coverage
Primary contact is not applying for coverage
If the primary contact is not applying for coverage, select No for the Are you applying for coverage question.
When the primary contact is not applying for coverage during an agent-assisted enrollment:
Providing SSN or immigration documentation is optional, but recommended to help avoid DMIs for the household members who are seeking coverage.
Additional applicants
Additional applicants
When adding additional applicants in the Household section during an agent-assisted enrollment, SSN is required for U.S. citizens who have been issued an SSN.
Non-U.S. citizens without an SSN can select This person doesn’t have an SSN. Selecting this checkbox creates an alert reminding the agent that immigration documentation will be required on the following pages.
Agents assisting with enrollment for applicants under 90 days old who have not yet been issued an SSN can also select This person doesn’t have an SSN. The date of birth field will be checked to confirm the applicant is under 90 days old.
If neither an SSN is provided nor This person doesn’t have an SSN is selected during an agent-assisted enrollment, an error message will appear. The application will not be able to proceed without this information for each applicant.
Adjusting applicant status
SSN and immigration documentation requirements update when an individual's applicant status changes.
When an individual's applicant status changes from non-applicant to applicant, an SSN or immigration documentation is required during the agent-assisted application. HealthSherpa will return the agent to the appropriate section to add the required information for each newly applying individual.
When an individual's applicant status changes from applicant to non-applicant, SSN or immigration documentation becomes optional during the agent-assisted application.
Data verification
CMS verifies each SSN and set of immigration documentation details entered on the application.
Verification errors that may display during the agent-assisted application include:
Social Security Number (SSN) required
Social Security Number (SSN) required
The Social Security Number (SSN) required error appears when the Social Security Administration (SSA) cannot match the applicant’s information to SSA records.
This error can happen when:
The applicant’s legal name does not match the name in SSA records
The applicant’s date of birth does not match SSA records
The SSN was entered incorrectly
Other application information does not match SSA records
To resolve the error, agents can:
Stay on the Invalid SSN screen and answer No to Does this data match this person?
Selecting No allows the agent to enter a different legal name or date of birth to submit an alternate Social Security name
Return to the Household section to review and correct the applicant’s name, date of birth, and SSN
Agents have a limited number of attempts to resolve this error. These limits are set by SSA.
If the attempt limit is reached, an SSN couldn’t be verified error will appear. The application cannot proceed without a verified SSN for the applicant.
Consumers without a verifiable SSN can:
Complete their own consumer-driven application
Continue the enrollment with agent assistance by calling the Marketplace Call Center
SSN couldn't be verified
SSN couldn't be verified
The SSN couldn’t be verified error appears when the Social Security Administration (SSA) cannot verify the applicant’s Social Security Number (SSN).
This error may appear when:
SSA determines the SSN is invalid
SSA determines the SSN does not belong to a living individual
The SSN required attempt limit has been reached
To resolve the error, agents can return to the Household section to review and correct the applicant’s name, date of birth, and SSN.
If the SSN still cannot be verified, the application cannot proceed without a verified SSN for the applicant.
Consumers without a verifiable SSN can:
Complete their own consumer-driven application
Continue the enrollment with agent assistance by calling the Marketplace Call Center
Immigration details couldn’t be verified
Immigration details couldn’t be verified
The Immigration details couldn’t be verified error appears when the Centers for Medicare & Medicaid Services (CMS) cannot verify the applicant’s immigration documentation.
This error may appear when:
The applicant’s immigration document details were entered incorrectly
The document type selected does not match the document information entered
The applicant’s name, date of birth, or other application information does not match the immigration document details
To resolve the error, agents can return to the Members section to review and correct the applicant’s immigration documentation details.
If the immigration documentation still cannot be verified, the application cannot proceed without verified immigration documentation for the applicant.
Consumers without verifiable immigration documentation can:
Complete their own consumer-driven application
Continue the enrollment with agent assistance by calling the Marketplace Call Center
Frequently asked questions:
How should agents answer these questions when completing a child-only plan?
Child-only Affordable Care Act (ACA) coverage is an individual health insurance policy for a child, without a parent or guardian included on the plan.
Children cannot be listed as the primary contact on an application. In most cases, the Marketplace application is completed by the person claiming the child on their taxes. This person is the primary contact for the application. Follow the steps outlined here when completing a child-only enrollments.
What are Data Matching Issues (DMIs)?
A Data Matching Issue (DMI) means information entered on a consumer’s subsidy application needs to be verified. Consumers often need to upload documents to resolve DMIs that arise.
Additional resources
For help using HealthSherpa or for other assistance, contact Agent Support. Agent Support is available by phone at (888) 684-1373, by email at Agent_Support@HealthSherpa.com, or by chat directly from your account.