Marketplace Lite

• Significant System Management Change
• PIA Validation (PIA Refresh/Annual Review)

MPL is the application process used through Healthcare.gov to support consumers in creating accounts, submitting applications, and receiving eligibility determinations for Marketplace coverage and related financial assistance programs. MPL does not retrieve consumer or household member records using personal identifiers such as name, Social Security Number (SSN), date of birth, or address. All records are retrieved exclusively through system‑generated identifiers, including application IDs, account IDs, and internal tracking numbers. This retrieval method applies to all categories of individuals, including applicants, dependents, identity‑verification participants, and system administrators.

1. Consumers Creating an Account or Applying for Coverage
   Information Collected: Full name; date of birth; address; email; phone number; SSN; citizenship/immigration status; pregnancy information; Tribal membership; veteran status; foster care information; relationship information; employment information; annual income; current health coverage; sexual orientation; sex assigned at birth; ethnicity; race; preferred spoken/written language.  
   Purpose: Supports account creation, identity verification, and eligibility determinations for Qualified Health Plans (QHPs), Advance Premium Tax Credits (APTC), Cost‑Sharing Reductions (CSR), Medicaid, and CHIP. Ensures accurate household composition and income assessment.  
   Retrieval Method: Not retrieved by PII. Records are retrieved using system‑generated identifiers (e.g., application ID, account ID).
2. Household Members (Dependents) 
   Information Collected: Name; date of birth; relationship to applicant; SSN (if provided); citizenship information; pregnancy status; Tribal membership; veteran status; foster care information; income and coverage information (if applicable).  
   Purpose: Required to determine eligibility for Marketplace coverage, APTC/CSR, Medicaid, and CHIP at the household level.  
   Retrieval Method: Not retrieved by PII. Records are retrieved using internal identifiers linked to the primary application.
3. System Users and Administrators 
   Information Collected: User ID; password; role‑based access information.  
   Purpose: Used to authenticate authorized personnel supporting MPL operations, maintenance, and troubleshooting.  
   Retrieval Method: Not retrieved by PII. Administrative records and access logs are retrieved using system‑assigned user identifiers.
4. Consumers Providing Coverage or Program Participation Information 
   Information Collected: Medicare coverage dates; Medicaid/CHIP status and reasons; Emergency Medicaid status; Unborn Child CHIP status; HRA/ICHRA information; QHP status; APTC/CSR determinations; Special Enrollment Period (SEP) types and dates.  
   Purpose: Supports eligibility determinations for Marketplace programs, financial assistance, and SEP qualification; enables coordination with federal and state health programs.  
   Retrieval Method: Not retrieved by PII. Records are retrieved using system‑generated identifiers.
5. Consumers Providing Documentation or Verification Responses 
   Information Collected: Verification issue identifiers; creation dates; issue types; status types; notices; Document Storage and Retrieval System (DSRS) identifiers.  
   Purpose: Supports resolution of eligibility verification issues, compliance with federal verification requirements, and documentation for program integrity.  
   Retrieval Method: Not retrieved by PII. Verification records are retrieved using issue identifiers or application IDs.

• Social Security Number
• Financial Account Info
• Name
• Date of Birth
• Employment Status
• E-Mail Address
• Mailing Address
• Phone Numbers
• Other - Pregnancy Information Federally Recognized Tribe Membership Relationships, Veteran Status, Foster Care Information, Citizenship Information, Dependent Information and Relationships, Employment Information, Annual Income, Current Healthcare Coverage, Ethnicity (Optional), Race (Optional), Sex- Assigned at Birth, Sexual Orientation, Spoken Language, Written Language, Coverage State, Policy Assistor Name; First Name, Last Name, Middle Name, Suffix Employer Name Medicare Coverage Dates Medicaid Program Information Member Enrollments and Coverage Records Premium Amounts and Coverage Dates Tax Credit Records and Amounts Special Enrollment Period Types (Life Events)

• Employees
• Public Citizens
• Vendors/Suppliers/Contractors
• Other - Health insurance agents and brokers

ACA 42 U.S.C. sections 1411(c),1411(d) and 1414; 18031, 18041, 18081—18083

45 CFR 155.200 

5 U.S.C. 301, Departmental Regulations

• In-person
• Online
• Hard Copy Mail/Fax

• Within the OPDIV

• Members of the Public
• Private Sector

OMB Control Number: 0938-1156
Title: Establishment of Qualified Health Plans and American Health Benefit Exchanges (CMS-10400).
Expiration Date: 09/30/2027

OMB Control Number: 0938-1191

Title: Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Health Benefits Exchanges, Medicaid, and Children's Health Insurance Program Agencies

Expiration Date: 09/30/2027

As part of the application process and creating an online account, an individual is presented with the Healthcare.gov Privacy Policy and must click a checkbox to acknowledge that they understand it. There is a link to the Privacy Policy at each stage of the application process, which also includes a Privacy Act Statement.

If an individual elects to apply by mail or online, the Marketplace Application form has a privacy notice on it that has been updated.

Users who register by phone or in person are also notified that their personal information will be collected for registration purposes.

For individuals who apply using a paper‑based Marketplace Application, the form includes a clearly displayed privacy notice and Privacy Act Statement before any fields requesting personal information. This ensures applicants understand the purpose, authority, and use of their information prior to completing or submitting the form.

Across all channels—online, paper, phone, and in‑person - MPL provides prior notice consistent with Privacy Act requirements, and no personal information is collected without informing individuals of the purpose, authority, and intended use of the information.

Since MPL is part of the Federally‑facilitated Marketplace (FFM) and operates through Healthcare.gov, MPL follows the FFM’s established process for notifying individuals of major system changes. When significant updates occur that affect how personal information is collected, used, maintained, or shared, the FFM posts updated notices, policies, and Privacy Act Statements directly on Healthcare.gov. This serves as the primary public‑facing mechanism for informing individuals of changes to data practices.

Also, when the Marketplace updates its data practices, the paper application form is revised accordingly, and the updated notice is provided to all individuals who apply using the paper form going forward. This ensures that paper‑based applicants receive the most current privacy information at the time of collection, consistent with Privacy Act requirements.

CMS has a National Institute of Standards and Technology (NIST)-compliant continuous monitoring program with regularly scheduled system audits, at least annually, and monthly/quarterly scanning to ensure system integrity and availability. As part of CMS, MPL is included within that monitoring system.

To ensure the integrity, availability, accuracy, and relevancy of the PII in MPL, the following methodologies are used. MPL users can manage their own PII by editing their profile after they have registered with the system for data integrity, accuracy and relevancy. MPL does a cross-check with FFM for data integrity and account management purposes. MPL is designed with encryption and role-based access controls to ensure data accuracy, and integrity. Encryption is applied to data in transit and data at rest.

• Administrators Explanation: Administrators may have incidental access to PII in the performance of their duties to support the MPL application process.
• Developers Explanation: Developers may also rarely have incidental access to PII in support of the MPL application. 
• Contractors Explanation: Direct Contractors may be in the role of administrator or developer and would have incidental access to PII as described within those roles.

Both CMS employees and contractor staff who access or operate MPL are required to complete the annual CMS Security Awareness training provided annually as computer based training (CBT) course. Contractors also complete their annual corporate security training.

Individuals with privileged access must also complete role-based security training commensurate with the position they are working in.

MPL follows the CMS Records Schedule that was published in April 2015 and the National Archives and Records Administration General Records Schedule (GRS) 5.1 and 5.2 (July 2017).

Specifically, for PII that is securely stored in the MPL database, the National Archives Records Association (NARA), General Records Schedule (GRS) 5.1 states that MPL will destroy such record immediately after copying to a recordkeeping system or otherwise preserving, but longer retention is authorized if required for business use. GRS 5.2 states that MPL will destroy records upon verification of successful creation of the final document or file, or when no longer needed for business use, whichever is later.

NARA Schedule: DAA-GRS2016-00160002 
DAA-GRS2022-00090002

Administrative:
- Mandatory security and privacy training for all users with access to MPL
- Enforcement of “need‑to‑know” and “minimum necessary” principles when granting access
- Role‑based access controls and periodic access reviews
- Documented policies and procedures governing proper handling of PII
- Incident response processes and continuous monitoring of compliance

Technical:
- Firewalls, intrusion detection and prevention systems, and continuous network monitoring
- Multi‑factor authentication for system access
- Encryption of data in transit and at rest
- Audit logging and automated alerts for anomalous activity
- Secure configuration baselines and vulnerability management

Physical:
- System servers housed in secure data centers with guard services, locked access points, and surveillance
- Environmental protections such as climate control, fire suppression, and redundant power
- Restricted physical access to authorized personnel only

Healthcare.gov

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• Web Beacons - Collects PII?: No
• Web Bugs - Collects PII?: No
• Session Cookies - Collects PII?: No
• Persistent Cookies - Collects PII?: No
• Other -  Measurement tools are used to monitor website traffic: frequency and repeated visits and busy (peak) periods.- Collects PII?: No