When purchasing or enrolling in a health insurance plan, you may need to provide documentation of coverage as part of the enrollment process or when filing taxes. You might even require proof of coverage when filing taxes!
Keep the necessary documents handy, as they can help expedite issues more easily. Learn what constitutes proof of insurance and where you can locate these essential records.
Insurance ID Cards
An insurance ID card serves as proof of your coverage and usually contains details regarding types and amounts of coverage you have, your member number, your employer (if group insurance), as well as insurer’s name and phone number. Before showing it to healthcare providers or authorities such as police officers or DMV employees, always review your card for any discrepancies or errors – particularly if requested to by them via an app or login into your account on mobile device. Many insurers – Progressive among others – now provide digital cards accessible via app on mobile device allowing access via app login allowing access directly via mobile device allowing legal compliance across most states when asked for proof.
Keep a paper copy handy just in case your phone battery dies or service cannot be obtained at the appropriate time.
Certificates of Insurance
Certificates of Insurance (COIs) provide proof that an insured possesses sufficient liability coverage. Business partners or customers often require certificates as an authorization to do business together, demonstrating they possess adequate protection in place.
COIs provide more information than just policy types, limits and expiration dates; in particular they include key pieces like policyholder names and account numbers as well as insurance company details – with NAIC numbers for easy reference.
Though requirements for COIs may differ depending on your business, some key items should always be included. A quality COI should include these:
Initial Certificate of Insurances (COIs) list the policy holder’s name and address to ensure that it reaches its intended recipient, whether that is a business or individual. Businesses often make sure they are named an additional insured on policies in case something goes amiss during construction work sites; having this guarantee gives businesses increased claims-making rights should anything go amiss during project execution.
An important section on a certificate of insurance (COI) is its Description of Operations section, where customized wording such as waiver of subrogation, primary and noncontributory coverages can be listed. Note that COIs should only display coverage as it existed at their date of issuance.
COIs typically include an agreement that states policyholders are responsible for notifying those requesting them of any changes or cancellations to coverage or policies, helping prevent parties from being held liable in case an insured’s failure to inform them results in loss.
Traditional methods for obtaining a Certificate of Insurance were both time consuming and inconvenient, often necessitating numerous emails or phone calls before all parties involved had all the information they required. Today’s technology makes this process much faster; for example some insurance brokers now allow users to instantly send their COI from an online account after purchasing their policy, providing quick, secure sharing with any third-party.
Eligibility Letters
Before we can process your Marketplace coverage application, we must verify both your identity and information submitted on it. In order to do this, you may have to upload documents proving your identity or verifying what was said on your application form. A notice in your account will inform you which documents are acceptable – remembering to submit them quickly so as to avoid delays – our coverage start date depends upon when we receive them, not when we pick a plan!
If you are a member of TRICARE, milConnect makes it easy for you to generate and print proof-of-coverage letters. Simply click “Obtain proof of health care coverage”, enter your valid email address into record, or contact your regional office if this feature does not work as expected.
Eligibility letters are used by state agencies to determine eligibility for programs like Medicaid and Children’s Health Insurance Program (CHIP). They can also serve as proof of insurance when applying for social security benefits, tax credits or disability claims.
Employing offices must inform employees about the need to verify family eligibility for FEHB and allow sufficient time for them to provide documents necessary for this verification process. In addition, an Employing office must make note on an Employees Health Benefit Election Form SF 2809 in their official personnel folder or equivalent personnel file and file this accordingly if information provided from family members was insufficient for evaluation; should such determination occur they must notify both family member(s) in question as well as provide copies of any decisions rendered with an explanation and notice of right of reconsideration regarding initial determination decision made.
If you are applying for an advance premium tax credit or re-enrolling during open enrollment, additional documents may be needed to verify your income and details. We will notify your Marketplace account if we require more information in order to approve or pay out the APTC; in that case, follow the instructions in your eligibility notice for how and where to send this documentation.
If a life change causes you to lose FEHB coverage, retroactive re-enrollment may be possible within 60 days of losing coverage; otherwise, monthly premiums could increase and you could incur higher charges than expected. Each situation varies in terms of how to request retroactive re-enrollment; please follow any relevant processes.
Tax Forms
Many individuals will receive one of three tax forms related to health insurance coverage: Form 1095-A, C or B from exchanges, employers or health insurers as a report of data to the IRS.
Most individuals who obtained coverage through the marketplace will receive Form 1095-A in January or February each year (depending on when their plan billed). This form will outline their exchange plan’s cost as well as any premium subsidy payments made on their behalf, which is necessary in completing Form 8962 to reconcile them against actual spending during that tax year.
Some individuals may receive multiple 1095-B documents during the year. This could be the result of switching jobs throughout and receiving coverage through each employer, as well as enrolling in different coverage options during that time, such as switching from HIP to GHI coverage with EmblemHealth plans or vice versa.
Members in these situations should reach out to their health care provider in order to request a replacement form and store it with all other important tax records, such as W-2 forms or any financial documents.
Individuals covered under Medicare, Medicaid or Children’s Health Insurance Program will likely receive a Form 1095-B as an annual statement from these programs. Sometimes an insurer will also send this form directly to an individual instead.
milConnect, the online TRICARE portal designed for military servicemembers and their families, offers recipients easy access to eligibility letters through milConnect. This tool offers one convenient location where recipients can view, save or print eligibility letters for all family members selected. Alternatively, they may visit their TRICARE Service Center and request one directly from the Benefits Center.
Though proof of health insurance is no longer required when filing taxes (unless one claims an individual mandate penalty), having these documents readily available could help avoid any hassle during an audit. As healthcare evolves rapidly, individuals and organizations alike should always be prepared with sufficient documentation.
