How does the Individual Marketplace Determine Eligibility?

The following phases illustrate the process of how the Individual Marketplace determines eligibility.

• Application: Upon request, agents and brokers are expected to assist consumers in submitting applications.

• Eligibility Determination: Application filers may request an eligibility determination for enrollment in a Qualified Health Plan and for insurance affordability programs.

• Verification: The Marketplace verifies applicants’ information using data from key federal agencies and other sources.

• Notification: The Marketplace provides applicants timely written notice of their eligibility determinations.