Basic (10-13)

RM 10260.001 Health Insurance Marketplaces and Social Security Administration (SSA) Contact

A. Introduction to Health Insurance Marketplaces

Under the Affordable Care Act, starting October 1, 2013, citizens and lawful aliens will be able to use Health Insurance Marketplaces to obtain health coverage. An application filed with a Marketplace is an application to determine eligibility or exemption for Insurance Affordability Programs. Insurance Affordability Programs include a qualified health plan, advance payments of the premium tax credit, cost sharing reductions, Medicaid, Children’s Health Insurance Program, and the basic health program. Individuals can file a health coverage application online, by telephone or by using paper forms.

NOTE: Individuals with Medicare do not need to enroll in the Marketplace.

B. The Marketplace verification process

When an individual files an application with a Marketplace, the Marketplace sends the Social Security number (SSN), name, and date of birth to the Centers for Medicare & Medicaid Services (CMS). CMS will electronically pass the information to SSA for verification. If the identity information does not match information in SSA records, CMS will notify the Marketplace. The Marketplace will notify the applicant of the inconsistency and provide instructions on how to resolve the inconsistency for health coverage eligibility.

C. The Marketplace identity resolution process

The Marketplace notification will instruct individuals whose information does not match SSA records, to send a copy of the Social Security card or tax forms to the Marketplace. The notification will also inform individuals to contact SSA’s National 800 number to resolve SSN discrepancies for purposes other than eligibility for health coverage.

D. References

RM 10205.001, How to Apply for a Social Security Card

RM 10212.010-RM 10212.165, Name Changes and Corrections on the Numident

RM 10212.200, Changing Numident Data for Reasons other than Name Changes

GN 00304.100, Use of Numident Death Data

To Link to this section - Use this URL:
RM 10260.001 - Health Insurance Marketplaces and Social Security Administration (SSA) Contact - 10/01/2013
Batch run: 01/31/2014