The Reasonable Opportunity Period (ROP) is a period of 90 days given to a consumer to provide proof of attested information submitted on an application when Pennie cannot electronically verify the attested information through trusted data sources.
When information reported to Pennie on an application, such as a customer’s household income cannot be electronically verified by Pennie, a Data Matching Inconsistency (DMI) is generated, and the customer has 90-days to submit documentation verifying their information. The customer will receive an eligibility determination notice from Pennie via their preferred mode of communication (email or postal mail) with information about how to resolve the DMI. Reminder notices will also be sent until the customer submits the correct documentation or the ROP has expired. This information will also be available on the customer’s account dashboard. The ROP is 90 calendar days and begins on the date the customer submits their application through Pennie.
The 90-day ROP will remain open until the requested documentation is provided by the consumer and approved by Pennie. It is important that consumers respond to Pennie’s request for additional documentation within the 90-day ROP. If the requested documentation is not received within the 90-day ROP, Pennie may take administrative action, such as removing the consumer’s eligibility for federal financial assistance (Advance Premium Tax Credits), or the insurance policy may be terminated. The consumer will again be notified by Pennie of any action taken on their account through their preferred mode of communication.
After the ROP expires, action can no longer be taken on that application, and the customer will need to reapply for coverage through Pennie. To avoid having administrative action taken on their account, consumers should read and respond to mail sent from Pennie to their home address, check their online Pennie inbox through their account portal for communications, and attempt to respond to Pennie’s request for additional documentation within the 90-day ROP.
If a consumer has questions regarding their monthly insurance premium, they should contact Pennie customer service directly at 1-844-844-8040.