How do I find out why my proof of coverage was declined?

If you're wondering why your proof of coverage was marked as noncompliant, you'll first want to check your member portal, in the Compliance section, to find a note from our Compliance team explaining why it was declined. 

What are common reasons why a proof of coverage is declined?

The most common reasons an ICHRA proof of coverage upload is declined include:

  1. Non Qualified Plan Type: For ICHRA, employee must have major medical individual or family health insurance, purchased on- or off-exchange, or Medicare Parts A+B or C. Read more about compliant plans here.

  2. Tax Credits: You cannot accept a Premium Tax Credit from the Exchange if you participate in ICHRA. If your proof of coverage shows a tax credit, you'll have to go back to the Exchange to correct it and re-submit.

  3. Incomplete information: The document you uploaded does not show your name, a date, or the plan name, and we may need additional information.

  4. Outdated information: We require documents dated within 30 days. If you upload an ID card, it may be declined with a request for more updated information.

  5. Incorrect information: For proof of coverage, we are looking for proof of your health insurance coverage. If you upload proof of your dental or vision insurance only, it will be declined as neither of those represents a qualified health insurance plan.

I saw what I was missing and found another proof of coverage document, how do I submit it?

You can use the "Edit" button under the Health Insurance tab to submit a new document to the compliance team.

If you still have questions about why your proof of coverage was declined, feel free to reach out by chatting with us or e-mailing!

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