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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Take Their Word for It?

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Question: Are you saying that the Exchange is going to accept whatever the applicant tells them without verification? That’s crazy.

Answer: Depending on an individual’s specific circumstances, the Exchange can verify the information, from the following sources:

  • Social Security Number (SSN) (Social Security Administration [SSA]) (An individual does not have to provide an SSN if he or she does not have one.)
  • Residency data
  • Citizenship status (SSA and Department of Homeland Security [DHS])
  • Immigration status (DHS)
  • American Indian or Alaska Native status
  • Household size (IRS)
  • Household income (IRS, SSA, Equifax, potentially other sources)
  • Access to other coverage (Medicaid, CHIP, Medicare, TRICARE, Department of Veterans Affairs, Peace Corps, other Marketplaces, the SHOP, and potentially other sources)

Finally, the Exchange can and will ask an applicant to fax a copy of a pay stub, utility bill, green card, etc. After all that, the Exchange may have to “take their word for it” and let the IRS sort it out at tax time.

1 Comment

“Social Security Number (SSN) (Social Security Administration [SSA]) (An individual does not have to provide an SSN if he or she does not have one.)”

This makes no sense. An individual with no SSN will qualify for exactly $0 in tax credits. So why bother to enroll through the Exchange?

“Citizenship status (SSA”

Has nothing to do with citizenship.

Although Covered California has indicated it will randomly verify eligibility, the federal requirement to do so has been abandoned this year. It’s strictly an honor system in 2013-2o14.

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