Q: Are there certain situations where a consumer with an expired income data matching issue would have their APTC reverted to $0?
A: Yes, a consumer with an income data matching issue could have his or her APTC and cost sharing reductions revert to $0 if he or she did not provide a Social Security Number (SSN) for every member of the household, or if the IRS does not have data on file for everyone in the enrollment group. Additionally, if the income information the Marketplace collected from trusted data sources at the time of the consumer’s determination is high enough, the consumer may not receive any APTCs if they fail to resolve their data matching issue by the indicated deadline.
What assisters can help consumers do in this situation?
- Encourage consumers with unresolved income data matching issue to report any change in expected annual household income by returning to the Marketplace application and entering a “change in circumstance.”
- Consumers can go back to the application and include an SSN, when available, which will increase the likelihood that application information can be verified electronically.
Note: If an applicant who has an SSN doesn’t enter it, they may need to provide more information later. Although many of the fields in the immigration section of the application are labeled as optional, we highly recommend that consumers input all information they have and fill out as many of the fields as possible. This increases the likelihood of a smooth and swift verification of immigration status, and increases the likelihood of a successful application submission. As such, we recommend that consumers seeking coverage provide their SSN if they have one, though it is optional. Non-applicants are not required to provide their SSNs unless all of the following are true:
- They have a spouse or tax dependent seeking APTC/CSR;
- The non-applicant is a tax filer;
- The non-applicant has an SSN; and,
- They filed a Federal tax return in the previous tax year.