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Privacy Act of 1974; Matching Program
Plain English Summary
The Department of Health and Human Services (HHS) has announced a new matching program that will help determine if individuals qualify for health coverage under the Affordable Care Act (ACA). This program will share information between HHS and the Office of Personnel Management (OPM) to check eligibility for health plans, affordability programs, and exemptions. Insurance agents should be aware of this program as it may affect how clients enroll and maintain their health coverage.
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In accordance with the Privacy Act of 1974, as amended, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) is providing notice of the re-establishment of a matching program between CMS and the Office of Personnel Management, "Verification of Eligibility for Minimum Essential Coverage Under the Patient Protection and Affordable Care Act through an Office of Personnel Management Health Benefit Plan". The matching program provides CMS and State Administering Entities with the Office of Personnel Management (OPM) data to use in determining individuals' eligibility to enroll in a qualified health plan through an exchange established under the ACA; for insurance affordability programs, certifications of exemption, and to make eligibility redeterminations and renewals, including appeal determinations.