Resolving Non-Compliance of Proof of Coverage
Proof of coverage is typically marked non-compliant because required information is missing, the document does not show qualifying individual health insurance coverage, or the documentation is outdated.
What information must proof of coverage include?
To verify ICHRA eligibility, documentation generally must show:
Your name as a covered member
Insurance company name
Plan name
Plan effective date
Evidence of active coverage
If you are requesting premium reimbursement, documentation may also need to show your monthly premium amount.
Common reasons proof of coverage is marked non-compliant
The document is missing required information
Common missing items include:
Member name
Insurance carrier name
Plan name
Effective date
Premium amount (when required)
If any required information is missing, the submission may be rejected.
The document is outdated
Proof of coverage should demonstrate current active coverage.
If the document is too old or does not reflect the current plan year, it may be marked non-compliant.
The plan is not eligible for ICHRA
ICHRA participants must maintain qualifying individual health insurance coverage.
Examples of plans that generally do not qualify include:
Short-term health insurance
Fixed indemnity plans
Other non-compliant coverage types
Medicare is generally considered eligible coverage for ICHRA purposes.
The document was uploaded to the wrong plan year
If proof of coverage was submitted under the wrong plan year, the document may be flagged during review.
Verify that documentation is uploaded to the correct coverage year.
Additional documentation is required
Some coverage types may require supplemental documentation to verify eligibility, effective dates, or active coverage status.
How do I correct a non-compliant submission?
Review the reason provided in your member portal.
Gather updated documentation that addresses the issue.
Navigate to the Health Insurance section of your account.
Edit the submission and upload the corrected document.
Resubmit for review.
What documents can I use as proof of coverage?
Examples may include:
Insurance bills
Coverage confirmation letters
Benefits election documents
Carrier account screenshots
Other documents showing active coverage and required plan information
The document must clearly display all required information.
Can I use screenshots?
Yes. Screenshots may be accepted if they clearly show all required information and are legible.
In some cases, multiple documents may be needed to provide all required details.
Why was my proof of coverage accepted last year but rejected this year?
Documentation requirements can vary by plan year.
A document that was accepted previously may not contain all information required for the current coverage year.
Key takeaway
Most proof-of-coverage compliance issues are caused by missing information, outdated documents, incorrect plan types, or plan-year mismatches. Review the reason provided in your member portal, upload corrected documentation, and resubmit for review.