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 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
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)
Rent checks or rental payment receipts
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.
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.
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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