Income Verification by Health Insurance Marketplaces

According to an FAQ on the CCIIO website, HHS has clarified that, for the federally-facilitated marketplaces, CMS intends to verify the income on 100% of the applications for advance payment of the premium assistance credit and cost-sharing reductions. The marketplaces will first try and verify the information electronically using available data from IRS, SSA, and Equifax. If the data on the application cannot be verified, the marketplace will request an explanation or additional documentation from the applicant to substantiate the income. For 2014, a state-based marketplace may choose to verify the income of a statistically significant sample size that is less than 100%, for applicants that meet certain requirements.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.