Dear Valued Agent/Broker Partners and Navigators,

The Exchange has received multiple questions regarding resolution of Data Matching Issues (DMI’s) for consumers. Please see additional details below:

Letter of Explanation (LOE):

The purpose of the LOE form is to allow consumers and brokers on their client’s behalf to file a written self-attestation to clear DMIs when the requested documentation is not available. As a reminder, the LOE form can only be used to clear income and NON-ESI MEC DMIs. 

When using the LOE form for Income DMI, please make sure you include an actual dollar amount. Without a dollar value, your form will be rejected, and you will have to upload another one. On the LOE form, it is important to note the reason for the self-attestation. For example, consumer recently reported a cut in hours/pay, or consumer believes this will be their income for 2023. 

When using the LOE form for NON-ESI MEC DMI, please make sure you include the reason that you are not able to provide the other MEC documentation. The explanation can be as simple as “Consumer has never had Off Exchange coverage and we are unable to provide documented proof.” If the LOE does not contain the reason your form will be rejected, you will have to submit another form. 

Reasonable opportunity period (ROP) Dates and Scenarios:

• Scenario 1: Consumer has a DMI from auto renewals but filed a new application during OE:

• If a consumer’s application comes back as not verified for income during auto renewals, the consumer will receive an open DMI to verify their income. They will have 90 days FROM the date that application was sent to the hub to clear that DMI i.e., app submitted on 11/01/2022 - the due date of expiration would be 01/30/2023. If the consumer or broker comes into the platform during OE i.e., 12/16/2022, that application will go to the hub for verification. If the consumer comes back as unverified for income again, the ROP clock does NOT start over. The consumer’s ROP expiration will remain the same as it was from the first unverified check date. This means that the consumer will still need to clear their income DMI by 01/30/2023.

• If a consumer comes back as not verified from income during auto renewals (11/01/2022), the consumer will receive an open DMI to verify their income. They will have 90 days FROM the date that application was sent to the hub to clear that DMI i.e., app submitted on 11/01/2022 - the due date of expiration would be 01/30/2023. If the consumer or broker comes in during OE i.e., 12/16/2022, that application will go to the hub for verification. If the consumer comes back as VERIFIED for income this will clear the prior DMI and documents will no longer be required, and consumer will not be affected by ROP.

• Scenario 2: Consumer has a DMI from auto renewals but receives multiple DMI’s during OE:

• Consumer receives an income DMI during auto renewals (11/01/2022) and expiration is set for 01/30/2023. The consumer has a new application filed on 12/16/22 and comes back as unverified for income and now NON- ESI MEC. The consumer will have two ROP expiration dates. The income DMI will keep the same expiration date of 01/30/2023 and the due date for the NON- ESI MEC expiration will be 03/16/2023. 

Please refer to this link for more information on DMI verifications.  

Please note: It is your responsibility as the agent/broker to assist your consumers with uploading documents to resolve DMI’s within the given time- frame. We heard your feedback and are working diligently to improve the DMI process.

Agent/ Broker Service Line 1-800-547-8156:

Monday – Friday, 9:00 a.m. – 5:00 p.m.