Siga las instrucciones aquí para traducir esta página a otro idioma usando Chrome.
The Federally Facilitated Marketplace (FFM) requires that applications associated with an agent's National Producer Number (NPN) include verifiable Social Security Numbers (SSNs) for all applicants over 90 days old.
Non-U.S. citizens with a qualifying immigration status can enter immigration document details instead if they do not have an SSN.
In this article we’ll cover:
SSN requirements at a glance
The Centers for Medicare & Medicaid Services (CMS) verifies SSNs and immigration documentation in real time during the application.
An application associated with an agent's NPN 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 at the time of application, can complete their own application by visiting HealthCare.gov or by calling the Marketplace Call Center.
If the information is not provided at the time of application or cannot be verified, a Data Matching Issue (DMI) may generate, and consumers will still need to provide the information later.
How SSN requirements appear in the application
SSN and immigration documentation requirements depend on whether each tax 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, and the application is associated with an agent's NPN:
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, the application is associated with an agent's NPN, 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, the application is associated with an agent's NPN, 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:
Providing SSN or immigration documentation is optional, but recommended to help avoid DMIs for the tax household members who are seeking coverage.
Additional applicants
Additional applicants
When adding additional applicants in the Household section, and the application is associated with an agent's NPN, 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.
This person doesn’t have an SSN can be selected for applicants under 90 days old who have not yet been issued 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, and the application is associated with an agent's NPN, 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 any application associated with an agent's NPN. 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 any application associated with an agent's NPN.
Data verification
CMS verifies each SSN and set of immigration documentation details entered on the application.
Verification errors that may display during an 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 application by visiting HealthCare.gov or 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 application by visiting HealthCare.gov or 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 application by visiting HealthCare.gov or by calling the Marketplace Call Center
Frequently asked questions:
What is a tax household?
A tax household is everyone included on one federal income tax return: the tax filer, their spouse if filing jointly, and anyone they claim as tax dependents.
Even if not everyone in the tax household is applying for Marketplace coverage, the Marketplace uses tax household information from the subsidy application to determine eligibility for coverage and financial assistance for those who are applying.
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 Support@HealthSherpa.com, or by chat directly from your account.