Understanding DMI's: How Data Matching Issues Can Impact Your ACA Clients

Data Matching Issues, or DMI’s, may not be the most common issue agents deal with day-to-day, but they are one of the main challenges that arise during the enrollment process. If left unresolved, DMI’s can lead to reduced benefits, plan cancellations, and clients losing trust in you as their agent. But the good news? With the right knowledge and tools, DMI’s can be caught early and handled easily.

Let’s break it down:

What is a DMI?

A DMI (Data Matching Issue) occurs when the information a client provides on their ACA application doesn’t match up with what the federal data sources have on file. This could be related to a few key things:

• Income

• Citizenship or immigration status

• Social Security Number

• Other key pieces of identifying information

When a DMI is flagged, the client is typically given 90 days to submit documentation that clears up the discrepancy. If they don’t respond in time—or if the documents are incorrect—their plan could be terminated, or their subsidy (APTC) could be removed.

How DMIs Affect Your Clients

• Coverage Disruption – Plans can be terminated if DMIs aren’t resolved in time.

• Loss of Subsidies – A client could suddenly owe full premium if their APTC is taken away.

• Client Confusion & Panic – Many clients don’t understand what a DMI is or how to fix it.

• Frustration With the System (or You) – Even though it’s not your fault, you may take the blame if they lose coverage.

Common Reasons DMI’s Occur

DMI’s can pop up for a variety of reasons—some are technical, and some come down to human nature. For example, clients may not feel comfortable giving out their full personal information (PII), especially if they’re unsure about how it’s being used. DMIs also tend to show up more frequently when agents are working with bad or inaccurate lead sources, where the data collected might be outdated or incorrect right from the start.

• Client estimates income that doesn’t match IRS records

• Missing immigration paperwork

• Social Security Number mismatch or typo

• Using nicknames or names that don’t match legal documents

How to Stay Ahead of DMIs

• Check DMI status regularly. In PolicySync, agents can view which clients currently have open DMI flags pulled directly from HealthSherpa data.

• Educate your clients. Let them know early that they may receive a DMI notice and walk them through how to upload documents if needed.

• Create a DMI follow-up system. Don’t rely on clients to handle it on their own. Check in, follow up, and remind them until it’s resolved.

• Act quickly. The 90-day clock starts ticking immediately, so time is of the essence.

How PolicySync Can Help

PolicySync lets you instantly see which of your ACA clients have active DMI flags, so you’re not caught off guard by coverage terminations or subsidy removals. This allows you to:

• Prioritize outreach to high-risk policies

• Send proactive reminders

Final Thoughts

DMI’s are part of the ACA world, but they don’t have to derail your client relationships or your business. With the right system in place—and tools like PolicySync—you can catch and resolve DMIs before they become major issues.

Educate, follow up, and stay proactive. Your clients will thank you for it.

Want to see how DMI tracking works in PolicySync? Visit www.policy-sync.com.