Upcoming Marketplace System Changes

Health Insurance Marketplace® sent this bulletin at 09/19/2024 01:46 PM EDT

agents and brokers - selling in the healthcare dot gov marketplace

Important Upcoming Block to Applications without Verified SSNs

The Centers for Medicare & Medicaid Services (CMS) is committed to protecting Marketplace consumers and is equally committed to program integrity. That’s why CMS is taking additional action to enhance program integrity, better protect consumers from coverage disruptions and support efforts to prevent unauthorized enrollments through the Marketplaces on the Federal platform.

Starting in October 2024, CMS will implement system changes to block applications submitted by agents and brokers without verifiable SSNs.

In October 2024, the Marketplace will only accept applications submitted by agents and brokers through the Classic Direct Enrollment and Enhanced Direct Enrollment (DE/EDE) pathways that include verifiable Social Security numbers (SSNs) for all individuals over 90 days old who are requesting coverage.
In December 2024, CMS plans to make additional updates to accept applications submitted by agents and brokers for noncitizen applicants who don't have SSNs but provide verifiable immigration document information on the application. The noncitizen applicant must be able to provide information from an immigration document that can be verified in real time by the Department of Homeland Security (DHS).

Consumers who do not provide this information to their agent or broker can apply for coverage through the Marketplace by submitting their own application through the Classic DE and EDE consumer pathways, through HealthCare.gov, or by calling the Marketplace Call Center with or without the help of an agent or broker.

Agents and brokers should evaluate their current workflows and ensure they have an actionable plan to collect SSNs from applicants who have them.

Almost all Marketplace applicants have SSNs, including U.S. citizens and most noncitizens who are eligible for Marketplace or Medicaid/CHIP coverage. There are certain noncitizens who are eligible for Marketplace coverage yet may not have SSNs. Applicants without SSNs are still eligible for Marketplace coverage, if otherwise eligible.

CMS expects that these system changes will greatly benefit consumers, agents, and brokers by reducing consumer burden related to unauthorized enrollments, data matching issue (DMI) resolution, and tax filing issues.

Additional resources:

Webinar Slides: Marketplace Consumer Consent and Compliance
FAQ: What should I do if my clients do not wish to provide me with their SSN?
FAQ: Why is it important to include SSNs on Marketplace applications?
Tip Sheet: Enrolling Consumers the Right Way: SSN Requirements
Tip Sheet: Enrolling Consumers the Right Way: SSN Requirements (Spanish)

Have questions? For additional assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

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