After you complete a client’s ACA application, there may be a Data Matching Issue (DMI).
A DMI occurs when there is an inconsistency between the information you entered for your client and the information the Marketplace has from other trusted sources, or if data on the application is missing or incorrect.
If this happens, return to the application with your client and confirm that all of the information is correct. If the information is correct and there is still a DMI, the Marketplace will ask you to submit documents to confirm the client’s information by a deadline.
Why Resolving a DMI is important
If acceptable documents are not submitted by the deadline in the notice, you could lose premium tax credits and other cost subsidies, or lose the Marketplace plan altogether.
Where You’ll See DMIs
Through the Marketplace
After filling out the application, you’ll need to navigate to the Next Steps section and read the eligibility determination notice to check for a DMI. If there is a DMI, you will see a statement reading “Important: You must submit documents”.
Through HealthSherpa
After enrolling your client, you’ll see a confirmation page with a summary of your client’s next steps, including any DMIs.
This information will automatically populate in your Clients tab.
From here, you can see which applications require follow-up documents. You can filter to see a specific document status or to see the closest deadlines.
To view a specific client’s document details, go to their Client Profile page (by clicking on their name or on the View button) where any follow-ups will be listed
The statuses mean the following:
Action Required – You need to upload a document.
Processing – This is a HealthSherpa-specific status that means the document you uploaded is awaiting review by HealthCare.gov.
Insufficient Docs – The last document you uploaded was determined by HealthCare.gov to be insufficient.
Expired – The deadline to get the document approved has passed.
Completed – Your document has been approved!
How to Resolve a DMI
After identifying that your client has a DMI, review the application for any typos. If you find mistakes, resubmit the application and see if the client still has a DMI.
If there were no mistakes or the resubmit didn’t solve the DMI, you or your client need to submit documents to resolve the DMI.
The documents required will depend on the type of DMI, and in some cases it may be necessary to submit multiple documents to resolve one DMI.
Common DMI types:
Annual Income
Citizenship/Immigration
Non-Employer Sponsored Minimum Essential Coverage
Click here to see a full list of DMI types and acceptable documents. CMS also has templates clients can use for income DMIs and confirming the client is not incarcerated or does not have Medicare,TRICARE, or Peace Corps coverage.