How to Submit Income Proof

If you receive a letter from the state health insurance marketplace about uploading proof of income, please do so before the deadline or you will lose the government subsidy to pay the full premium or even lose your coverage.

Types of documents accepted by state

Income from a job

  • Paycheck stubs showing employee information, pay date or pay period, and gross amount of pay, for the 4 weeks prior to the date listed on your notice. 

  • 1040 federal or state tax return from the previous year if representative of attested income. 

  • Wages and tax statement (W-2 and/or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA, 1099DIV, 1099SS, 1099INT) showing first/last name, income amount, year, and employer name (if applicable). 

  • A signed earning statement from your employer showing first/last name, company contact information and gross pay information, signed by the employer and dated. 

NOTE: If you are seasonally employed, any of the proofs above should include information about the duration of your employment. 


Self-Employment Income 

  • Self-Employment ledger documentation showing first/last name, company name, and income amount. If you’re submitting a self-employment ledger, include the dates covered by the ledger, and the net income from profit/loss (can be a Schedule C, the most recent quarterly or year-to-date profit and loss statement, or a self-employment ledger). 

  • 1040 SE with Schedule C, F, or SE (for self-employment income) 

  • 1065 Schedule K1 with Schedule E 

  • Tax return 

  • Bookkeeping records 

  • Receipts for all allowable expenses 

  • Signed timesheets and receipt of payroll, if you have employees 

  • Most recent quarterly or year-to-date profit and loss statement 


Social Security Disability or Retirement Benefits

  • Award letter/certificate dated within the last year 

  • Annual benefit statement 

  • Correspondence from the Social Security Administration with your award status (denied, award amount, still pending) 


Rental Income 

  • Rent checks or rental payment receipts 

  • Current lease 

  • Signed letter from tenant with monthly rent amount 

  • Filed tax return if representative of attested rental income 


Other Sources of Income 


  • Agricultural income certificate 

  • Alimony received: court order stating alimony amount or signed statement from individual providing alimony with amount and frequency. 

  • Annuity statement 

  • Bank or investment fund statement 

  • Cost of living adjustment letter and other benefit verification notices 

  • Farm Income (See acceptable proof of “Self-Employment Income” listed above) 

  • Foreign-Earned Income (See acceptable proof of “Income from a Job” listed above) 

  • Gambling Income: Form W-2G 

  • Interests and dividends income statement 

  • Letter, deposit, or other proof of deferred compensation payments 

  • Letter, deposit, or other proof of travel/business reimbursement pay 

  • Loan statement showing loan proceeds 

  • Military Leave and Earnings statement 

  • Pay stub indicating sick pay 

  • Pay stub indicating substitute/assistant pay 

  • Pay stub indicating vacation pay 

  • Prizes, settlements, and awards, including court-ordered awards letter 

  • Proof of bonus/incentive payments 

  • Proof of gifts and contributions 

  • Proof of inheritances in cash or property 

  • Proof of residuals 

  • Proof of severance pay 

  • Proof of strike pay and other benefits from unions 

  • Rental, real estate, royalties, partnerships, S-Corps, trusts: rent checks or rental payment receipts, current lease, signed letter from tenant with monthly rental amount, royalty checks, or financial record of payment from trusts 

  • Royalty income statement or 1099-MISC 

  • Sales receipts or other proof of money received from the sale, exchange, or replacement of things you own 

  • Statement of pension distribution from any government or private source 

  • Worker’s compensation letter

To ensure your application is accepted, please use the following format as a reference for your application ID, name, documents enclosed, and the total amount of income in your materials.

View Sample Template

There are 3 ways to upload the proof of income:

1. Send your proof of income to us via Wechat (ePro2158258435), text message(215-825-8435) or Document Drop Box. We’ll upload it for you.

2. Mail a copy of the documents to the address they gave.

    • Make sure to write your name and Application ID, which would be included in your eligibility notice, on all your documents. You should keep the original documents for your records. 

    • Include the notice’s cover sheet with the barcode when mailing your documentation.

3. The fastest option is to upload documents online.

Please go to Marketplace, enter your zip code and select the site in your region. Once you are logged in, you can upload files. 

If you can’t upload by yourself please choose the first way. Please contact us at 215-825-8435 if you have any questions.

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