The Dept. of Health and Human Services is explaining how it will verify whether a person’s income makes them eligible for a premium tax credit and cost-sharing reductions. The exchanges will use tax filings and Social Security data to verify household income. In many cases, they will also use current wage information that is available electronically. If Equifax data does not substantiate the inputted information, the exchange will request an explanation or more documentation to substantiate the applicant’s household income.
For 2014 only, HHS will allow an exchange to request more documentation from a statistically significant sample under the following circumstances:
• When the exchange has IRS data.
• The application filer inputs projected annual household income that is more than 10% below IRS and SSA data.
• Equifax data is unavailable.
• The individual does not provide a reasonable explanation for the inconsistency between the attestation and IRS and SSA data.
