Individual Marketplace Review for Returning Agents and Brokers...Welcome to the Individual...

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Topic: 1 of 7: Welcome to the Individual Marketplace Review for Returning Agents and Brokers Page: 1 of 4: Welcome to the Individual Marketplace Review for Returning Agents and Brokers

Long Description Animated introduction screen containing the following text at the top and left of the screen: Welcome to the Individual Marketplace Review for Returning Agents and Brokers. Beneath this text on the left is the logo for the Department of Health & Human Services (HHS), which is made up of the profiles of people, stacked on top of each other, resulting in the profile of an eagle. The words "Department of Health & Human Services USA" form a circle that extends out and to the left from the profiles. To the right of the logo are the words “Health Insurance Marketplace®.” On the right side of the screen are three images from the module representing agents and brokers and module-specific concepts.


Page: 2 of 4: Disclaimer

Page Text The information in this training was current at the time it was published or uploaded onto the Web. Eligibility policies and Marketplace requirements may change so links to the source documents have been provided within the document for your reference. This training is not intended to grant rights or impose obligations. It may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage learners to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of the requirements. This communication was printed, published, or produced and disseminated at U.S. taxpayer expense. Alt Text A page of text with horizontal lines across it; a red horizontal box containing the word "Disclaimer" within it


Page: 3 of 4: Introduction

Page Text Welcome to the Individual Marketplace Review for Returning Agents and Brokers. This training should take about 40 minutes to complete. During this this review, you will: • Review the eligibility criteria for individuals to enroll in a qualified health plan (QHP) through the Health Insurance

Marketplace®* • Review the rules for QHP enrollment for individuals eligible for Medicare, Medicaid, or the Children’s Health Insurance

Program (CHIP) and individuals with employer-sponsored coverage • Review how to assist consumers with submitting information or taking action in response to a notification that they need to

resolve a data matching issue • Review the eligibility requirements for advance payments of the premium tax credit (APTC) and cost-sharing reductions

(CSRs) • Review the enrollment periods and coverage effective dates available through the Marketplace • Review the enrollment pathways available to agents and brokers, as well as tips for ensuring an agent’s or broker’s

National Producer Number (NPN) is recorded and retained when assisting with consumer enrollments * The term "Health Insurance Marketplace®" is a registered trademark of the U.S. Department of Health & Human Services (HHS). When used in this document, the term “Health Insurance Marketplace®” or “Marketplace” refers to Federally-facilitated Marketplaces (FFMs), including FFMs where states perform plan management functions, and also refers to State-based Marketplaces on the Federal Platform (SBM-FPs).


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Page: 4 of 4: Structure and Navigation

Page Text This training contains a bookmarking feature that allows you to stop at any point and return later to continue where you left off. To successfully complete this review, you must complete each of the following scenarios:

1. Scenario 1: Eligibility Criteria for Enrolling in a QHP 2. Scenario 2: Helping Consumers Resolve a Data Matching Issue 3. Scenario 3: Eligibility for Financial Assistance Through the Marketplace 4. Scenario 4: Open Enrollment Period and Special Enrollment Periods 5. Scenario 5: Enrollment Pathways and Recording Your NPN on Applications 6. Key Points

Training Navigation

• Selecting Back takes you to the previous page. • Selecting Next takes you to the next page. • Selecting Menu takes you to the menu page and provides access to any of the topics. • Selecting Help displays information about accessibility and functionality. • Selecting Glossary displays a list of terms and acronyms used. • Selecting Exit closes the training.


Alt Text A road post with signs pointing in different directions; each sign contains a specific topic title from this lesson (Scenario 1, Scenario 2, etc.).


Topic: 2 of 7: Scenario 1: Eligibility Criteria for Enrolling in a QHP Page: 1 of 6: Scenario 1: Narrative

Page Text Shanika Miller, 25, lives in Tampa, Florida, with her parents, Malik and Kayla, and her sister, Jada, who is 16 years old. Malik is 65 years old and is retiring soon from his job for the past 38 years in hotel housekeeping. Kayla is 52 years old and is unemployed due to a disability. Shanika has health coverage for herself through a health plan sponsored by her employer, but she is reaching out to you wondering whether members of her family can apply for health coverage through the Marketplace. Alt Text A woman with her arms crossed in front of her body; her right hand is beneath her chin and her left hand is supporting her right elbow.


Page: 2 of 6: Scenario 1: Question 1

Prompt Select the best answer and then click Check Your Answer. Question Shanika asks whether there are any specific criteria that individuals have to meet in order to be eligible to obtain insurance through the Marketplace. How do you answer Shanika’s question? Options


A. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be U.S. citizens or nationals, or lawfully present non-citizens, and expect to remain so for the entire period coverage is sought; and (3) Not be incarcerated, other than incarceration pending the disposition of charges.

B. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be U.S. citizens or nationals, or lawfully present non-citizens, and expect to remain so for the entire period coverage is sought; and (3) Not have health coverage for at least one year.

C. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be employed for at least one year in the state where they will apply for coverage and enroll in a QHP; and (3) Not be incarcerated, other than incarceration pending the disposition of charges.

Correct Answer A Positive Feedback You are right! These are the three correct criteria. Note that while any individual meeting these criteria may enroll in QHP coverage through the Marketplace during the annual Open Enrollment period, QHPs are generally not intended for individuals who are eligible for or enrolled in other types of minimum essential coverage, such as employer-sponsored coverage, Medicaid, CHIP, TRICARE (the Department of Defense heath care program), and certain other types of coverage.



Prompt Select the best answer and then click Check Your Answer.

Question Shanika has another question. After her dad retires, he and her mom (who is covered under his employer’s group health plan) will no longer have health coverage. She is wondering whether her parents are eligible for Marketplace coverage or government-sponsored programs. What should you advise Shanika?


Options

A. Her parents may both be eligible for Medicare since her dad is age 65 and her mom is under age 65 with a disability. You point out that the Marketplace does not determine eligibility for the Medicare program.

B. Her parents should wait until several months after Malik's retirement to get their finances in order, and then follow up with you for assistance in seeking health coverage through the Marketplace.

C. Her parents may be eligible to enroll in a Marketplace plan. You tell Shanika that you can assist her parents with eligibility, plan selection, and enrollment.

Correct Answer A

Positive Feedback You are right! Shanika’s parents may both be eligible for Medicare and should explore that option first. Consistent with the longstanding prohibition on the sale of duplicate coverage to Medicare beneficiaries, it is illegal to sell or issue a QHP to a Medicare beneficiary with the knowledge that the QHP duplicates the beneficiary’s Medicare benefits. As an agent or broker, you should protect yourself by asking each applicant about his or her Medicare status and, for consumers who may be eligible for Medicare, direct them to contact Medicare for information on eligibility, the enrollment process, and enrollment timeframes. Remember, since Shanika’s parents are losing health coverage when her dad retires, they may have to pay the entire cost of all medical care received.

http://www.medicare.gov/




Question Shanika brings her parents, Malik and Kayla, to see you because they want health coverage for their younger child, Jada. You assist them in completing the Marketplace application on behalf of Jada, and they receive an eligibility determination that says Jada may be eligible for Medicaid/CHIP. You tell Malik and Kayla that Jada’s application will be transferred to the Florida Medicaid/CHIP office, which will follow up with them to complete Jada’s enrollment. However, they find this objectionable as they are anxious to complete the process, and they ask you what they can do to enroll Jada in health coverage today. What should you advise them to do?


Options

A. Tell them that they have no other options and should wait for the Florida Medicaid/CHIP office to contact them to complete the enrollment.

B. Tell them that they may enroll Jada in a QHP available through the Marketplace, although it is likely not in their financial best interests to do so.

C. Tell them that they should appeal the eligibility determination because this may expedite the Florida Medicaid/CHIP enrollment process.

Correct Answer B

Positive Feedback You are right! Since Jada may be eligible for Medicaid/CHIP, it is likely not in her parents’ financial best interests to enroll her in a Marketplace QHP because they will not be eligible to receive either APTC or income-based CSRs and would be required to pay the full premiums for her coverage. If Malik and Kayla insist on this option and want to enroll Jada in a QHP, they should submit a new application and indicate that they do not want help paying for coverage. Remember, the appeals process is for consumers who disagree with the eligibility determination, so it would be inappropriate to file an appeal in this situation.




Question After you have finished your discussion with her parents, Shanika starts to wonder if she can get a better deal on her own health coverage if she disenrolls from her employer’s health plan and seeks coverage through the Marketplace. She asks for your advice on whether she can apply and get coverage through the Marketplace. What should your answer be?


Options

A. You are not eligible to enroll in a QHP through the Marketplace since you are already receiving employer-sponsored coverage.

B. Even though you are receiving employer-sponsored coverage, you may purchase a QHP through the Marketplace as long as you meet the eligibility criteria. However, you need to keep in mind that, if you decide to go that route, you will not be eligible for financial help, such as APTC and income-based CSRs, to help pay for coverage through the Marketplace, so this option may not be in your best financial interest.

C. You should definitely purchase a QHP through the Marketplace since you will be eligible for APTC and income-based CSRs that will make your monthly payments and out-of-pocket expenses more affordable.

Correct Answer B

Positive Feedback You are right! Shanika may enroll in a QHP through the Marketplace as long as she meets the eligibility criteria. However, individuals who are enrolled in employer-sponsored coverage, or are eligible for employer-sponsored coverage that is affordable and meets the minimum value standard, are NOT eligible for APTC and income-based CSRs.


Page: 6 of 6: Scenario 1: Completion

Page Text In this scenario, you learned that: • To be eligible to obtain health coverage through the Marketplace, an individual must:

o Be a resident of the state where he or she will apply for coverage and enroll in a QHP; o Be a U.S. citizen or national, or a lawfully present non-citizen, and expect to remain so for the entire period coverage

is sought; and o Not be incarcerated, other than incarceration pending the disposition of charges.

• QHP coverage through the Marketplace is generally not intended for individuals who are eligible for or enrolled in other types of minimum essential coverage.

• A person who is eligible to receive Medicaid or CHIP, or who is eligible for employer-sponsored coverage that is affordable and meets the minimum value standard, may purchase QHP coverage through the Marketplace, but is not eligible for financial help, such as APTC and income-based CSRs, to help pay for QHP coverage.

You have completed Scenario 1. Return to the Menu and proceed to Scenario 2. Alt Text A woman has her right arm extended out to her side and her right hand is open faced directing your attention the text on the left of the screen.


Topic: 3 of 7: Scenario 2: Helping Consumers Resolve a Data Matching Issue Page: 1 of 6: Scenario 2: Narrative

Page Text Mike Bradshaw is an agent in Charlotte, North Carolina, who is meeting with a consumer, Maheen Sangha, to help her complete a Marketplace application via HealthCare.gov. When they view Maheen’s eligibility notice, it says Maheen is eligible for a QHP through the Marketplace, the APTC, and income-based CSRs. However, the notice also says “Send the Marketplace more information” and indicates there is an issue in the data used to establish Maheen’s immigration status. Alt Text A woman and a man looking at a laptop screen




Question How will the notice of a Marketplace issue impact Maheen’s eligibility to enroll in a QHP through the Marketplace?


Options

A. It means Maheen must provide an attestation indicating she is eligible to enroll in a Marketplace QHP; this attestation will resolve any data matching issues.

B. It means Maheen cannot enroll in a QHP through the Marketplace; she must resolve her eligibility issue and then wait until the next Open Enrollment period to obtain health coverage through the Marketplace.

C. It means Maheen may enroll in a QHP and receive APTC and income-based CSRs through the Marketplace, but she must take action to resolve the issue between her Marketplace application and the information contained in the approved electronic sources the Marketplace uses to verify her eligibility.

Correct Answer C

Positive Feedback You are right! If there are issues between a consumer’s application and the information contained in the approved electronic sources, the Marketplace produces an initial eligibility notice that includes a temporary 90-day eligibility determination, and a list of any "data matching issues," along with instructions for how they can be resolved. If the consumer does not resolve the issue, he or she may lose eligibility for coverage through the Marketplace or modification of APTC, if applicable. The most common types of data matching issues are related to annual household income, citizenship, and immigration status. (In the case of a citizenship or immigration status issue, the length of the resolution period is 95 days.) Remember, the consumer may attest to having eligibility for health coverage, but that attestation is only good for a 90-day/95-day period, during which the consumer must provide satisfactory documentation to the Marketplace to resolve the inconsistency; otherwise, he or she may lose eligibility for health coverage through the Marketplace.



Prompt Select all that apply and then click Check Your Answer.

Question Mike reviews the eligibility results with Maheen and explains to her that she may still enroll in a QHP through the Marketplace with APTC and the income-based CSRs that she qualified for, but that the Marketplace needs additional information regarding her immigration status to resolve a data issue. What advice should Mike share with Maheen for resolving the data matching issue?


Options

A. He should encourage Maheen to submit the requested information as soon as possible, preferably by uploading the requested documents through her HealthCare.gov account.

B. He should emphasize that if Maheen does not send the requested documentation by the deadline, she may lose eligibility for health coverage through the Marketplace.

C. He should direct Maheen to start over with a new Marketplace application and answer the immigration status questions differently to see if she gets a different eligibility determination result.

Correct Answer A, B

Positive Feedback You are right! Agents and brokers can play an important role in helping consumers understand and follow the correct process to resolve data matching issues. Digital upload is the fastest way to submit the requested information to the Marketplace. For screen-by-screen uploading directions, see this resource. Agents and brokers may be able to use the Enhanced Direct Enrollment Pathway to upload their clients’ documents to resolve data matching issues and to view of the status of those issues. To find out more about specific Enhanced Direct Enrollment features, contact the issuer or web-broker directly. Mike should make sure Maheen understands the process and deadline for resolving the data matching issue, and knows the consequences of not taking the requested action.

https://www.healthcare.gov/downloads/how-to-submit-documents-to-confirm-application-information.pdfhttps://data.healthcare.gov/issuer-partner-lookup


Page: 4 of 6: Scenario 2: Question 3 Narrative

Page Text Eight months later, Maheen calls Mike and is upset because she has just received a Marketplace notice informing her that she may be enrolled in a Marketplace plan with APTC or income-based CSRs and enrolled in Medicaid in North Carolina. The notice also indicates that she should act immediately to update her Marketplace coverage because she is no longer eligible for APTC or income-based CSRs if she does, in fact, have Medicaid coverage that qualifies as minimum essential coverage.

Mike knows that this notice was generated by the Marketplace data matching that it conducts periodically throughout the year to identify consumers who are “dually enrolled” in both Marketplace coverage with APTC and/or income-based CSRs and in Medicare, Medicaid, or CHIP that qualifies as minimum essential coverage.*

Mike explains the data matching process to Maheen and discovers that, in Maheen’s case, she is receiving this notice because she applied for Medicaid directly with the North Carolina state Medicaid agency and was determined eligible, but she failed to terminate her Marketplace coverage with APTC and income-based CSRs.

*Note: Most Medicaid coverage is considered minimum essential coverage. Some forms of Medicaid cover limited benefits (like Medicaid that only covers emergency care, family planning, or pregnancy-related services) and are not considered minimum essential coverage. For more information on which Medicaid programs are considered minimum essential coverage, visit HealthCare.gov. Most CHIP coverage is also considered minimum essential coverage. Medicare Part A and Medicare

https://www.healthcare.gov/medicaid-limited-benefits/


Part C (otherwise known as Medicare Advantage) are considered minimum essential coverage. Medicare Parts B or D alone are not considered minimum essential coverage.

Alt Text Woman with her back to the camera looking at a cellphone in her right hand




Question Since Maheen is enrolled in Medicaid, what should Mike advise her to do in response to this notice?

Options

A. She should take no action in response to this notice.

B. She should immediately contact the applicable Marketplace to end her Marketplace coverage with APTC.

C. She should contact the North Carolina state Medicaid agency to end her Medicaid coverage and keep her Marketplace coverage with APTC and income-based CSRs.

Correct Answer B


Positive Feedback You are right! Consumers can end their Marketplace coverage online by visiting HealthCare.gov or by contacting the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). If Maheen takes no action by the deadline specified in the notice she received, the Marketplace will end any APTC/CSRs being paid on her behalf, and her Marketplace coverage will continue without financial help. You can review the following resources for additional information regarding how consumers can end a Marketplace plan in response to a notice resulting from periodic data matching.

• More information about ending Marketplace coverage with APTC/CSRs, and instructions on how to keep a Marketplace plan without APTC and CSRs, are available at this link.

• More information about updating a Marketplace application and reporting a change is available at this link.

Remember, because she is eligible for Medicaid, Maheen may cancel her Medicaid enrollment and keep her QHP coverage through a Marketplace, but she would not be eligible for APTC or income-based CSRs to help her pay for that coverage. Consumers who do not think they are enrolled in Medicaid or CHIP should contact their state Medicaid or CHIP agency to confirm that they are not enrolled in or eligible for Medicaid or CHIP, and update their Marketplace application accordingly to tell the Marketplace they are not enrolled in Medicaid or CHIP.

https://www.healthcare.gov/how-to-cancel-a-marketplace-plan/http://www.healthcare.gov/medicaid-chip/cancelling-marketplace-plan/



Page Text In this scenario, you learned that: • Agents and brokers can play an important role in helping consumers understand and take the required steps to resolve

issues identified through the Marketplace data matching process. • Consumers who are dually enrolled in both Marketplace coverage with APTC and/or income-based CSRs and in Medicaid

or CHIP that qualifies as minimum essential coverage must either end their Marketplace coverage or update their Marketplace application to tell the Marketplace that they are not enrolled in Medicaid or CHIP by the deadline on the notice they receive; otherwise, the Marketplace will end any APTC/CSRs being paid on their behalf, and their Marketplace coverage will continue without financial help.

You have completed Scenario 2. Return to the Menu and proceed to Scenario 3. Alt Text Image of the back side of a computer with several yellow Ethernet cables plugged into it


Topic: 4 of 7: Scenario 3: Eligibility for Financial Assistance through the Marketplace Page: 1 of 5: Scenario 3: Narrative

Page Text Eligibility for Financial Assistance through the Marketplace You are meeting with Roger and James Hansen, a married couple with no dependents, who are interested in exploring their eligibility for financial assistance if they choose to enroll in a QHP through the Marketplace. Roger and James are both U.S. citizens and meet the other eligibility criteria for enrollment in a QHP, and they use the “Married Filing Jointly” filing status on their federal income tax return. Alt Text A woman and two men are meeting and sitting around a table in an office.




Question What other eligibility criteria must Roger and James meet to qualify for APTC?

Options

A. Either Roger or James must be eligible to enroll in other minimum essential coverage, such as employer-sponsored coverage or a government-sponsored program.

B. They must have been enrolled in a Marketplace QHP for the previous plan year; otherwise, they may claim the tax credit on their federal income tax return, but they may not qualify to receive the premium tax credit in advance.

C. They must have an annual household income between 100% and 400% of the federal poverty level (FPL).

Correct Answer C


Positive Feedback You are right! Eligibility for APTC is based on projected annual household income, projected family size, and other eligibility criteria for the coverage year. Remember, a person eligible to enroll in employer-sponsored coverage that meets affordability and minimum value standards or a government-sponsored program that meets the minimum essential coverage requirements is not eligible for APTC. In addition, if a consumer qualifies for the premium tax credit based on his or her income estimate, that consumer is eligible for APTC to lower the monthly premium payment, regardless of his or her history of Marketplace participation.




Question The Hansens have an annual household income of approximately $38,000, which puts them at about 225% of the FPL. After you assist them with completing the Marketplace application, their Marketplace eligibility determination confirms they are eligible to enroll in a QHP with APTC. In addition, the determination notes that their income qualifies them for CSRs, which may save them money on out-of-pocket-costs like deductibles, copayments, and coinsurance. When you start reviewing their QHP options with them, Roger and James ask you what they need to do to ensure they get the CSRs for which they qualify. What should you advise Roger and James?


Options

A. They should enroll in a Bronze plan through the Marketplace.

B. They should enroll in a Silver plan through the Marketplace.

C. They should enroll in a catastrophic plan through the Marketplace.

Correct Answer B

Positive Feedback You are right! Consumers who qualify for income-based CSRs can only get these savings if they enroll in a plan in the Silver plan category. (Note: Consumers who are members of federally recognized tribes or shareholders in Alaska Native Claims Settlement Act [ANCSA] Corporations may receive CSRs if they enroll in a plan in any plan category, except for catastrophic plans.) Remember, while a Silver plan may have a monthly premium that is higher than a Bronze plan’s premium, the Hansens may spend less on health care overall if they enroll in a Silver plan so they can apply the CSRs to their health care expenses.




Question Before you end your meeting with the Hansens, you encourage them to report changes in their income to the Marketplace throughout the year as they happen so that the Marketplace can adjust their APTC, if needed. You also explain to them that they will have to use their actual household income to reconcile the allowed premium tax credit with the APTC paid on their behalf for their QHP premiums when they file their federal tax return for the applicable plan year. Which of the following scenarios could apply for the APTC reconciliation process?


Options

A. If the amount of the allowed premium tax credit is more than the amount the Hansens chose to have paid directly to the issuer, or received as APTC (i.e., a net premium tax credit), the difference (called "net premium tax credit") will increase the Hansens’ refund or reduce their tax liability.

B. If the amount of the allowed premium tax credit is less than the APTC, excess APTC was paid on the Hansens’ behalf. The Hansens must enter the APTC amount on their return and will be required to repay all or a portion of it when filing the tax return. The excess APTC repayment amount may be limited for tax filers with actual annual household income below 400% of the FPL for the tax filer’s family size..

C. If the Hansens do not file a federal tax return for the year in which APTC were paid on their behalf, the Marketplace will discontinue their future eligibility for APTC and CSRs to help pay for their Marketplace health insurance coverage.

Correct Answer A, B, and C

Positive Feedback You are right! Any of these scenarios may apply. As an agent or broker, you are prohibited from helping consumers with filing their taxes unless you are also a licensed tax professional. However, you may play an important role in helping consumers make the connection between reconciling APTC paid on their behalf when they file federal income taxes. You should also encourage consumers to promptly report changes in circumstances to the Marketplace as they happen to allow the Marketplace to update the information used to determine eligibility for APTC and to adjust the APTC amount. This adjustment decreases the likelihood of a significant difference between the tax filer’s APTC and his or her allowed premium tax credit. Changes in circumstances that can affect the amount of the actual premium tax credit include: increases or decreases in household income, marriage, divorce, birth or adoption of a child, other changes in household composition, gaining or losing eligibility for a government-sponsored program or employer-sponsored health care coverage, and change of address.



Page Text In this scenario, you learned that: • Consumers who meet specified criteria for projected annual household income, projected family size, and other eligibility

criteria for the coverage year may qualify for financial assistance to help them afford health coverage purchased through the Marketplace. This assistance may include APTC to lower their monthly premium payments and income-based CSRs that reduce their out-of-pocket expenses.

• Consumers who choose to apply some or all of the premium tax credit towards QHP premium costs on an advance basis must reconcile the allowed premium tax credit with the advance payments made on their behalf when they file their federal tax returns for the applicable plan year.

You have completed Scenario 3. Return to the Menu and proceed to Scenario 4. Alt Text Image of a person's hand holding an IRS 1040 tax form


Topic: 5 of 7: Scenario 4: Open Enrollment Period and Special Enrollment Periods Page: 1 of 4: Scenario 4: Narrative

Page Text Magda Lorence, a 32-year-old female, lives in Missouri, and is exploring her options to finding health coverage for herself. She sent you an email last night asking when the next Marketplace Open Enrollment period is. She is wondering if the enrollment period starts and ends at the same time every year. You are going through your emails this morning and are now getting ready to reply to Magda’s question. Alt Text A woman sitting at a desk with a laptop in front of her and looking at an index card




Question You inform Magda she may apply for an eligibility determination and enroll in a Marketplace QHP during the annual Open Enrollment period for plan year 2021, which is:

Options

A. October 1, 2020 through January 31, 2021

B. November 1, 2020 through December 15, 2020

C. November 15, 2020 through February 15, 2021

D. November 1, 2020 through January 31, 2021

Correct Answer B


Positive Feedback You are right! The Marketplace Open Enrollment period for plan year 2021 is between November 1, 2020 and December 15, 2020. Consumers must complete their plan selections by December 15 for their health coverage to become effective on January 1. There are no opportunities to make an Open Enrollment plan selection after December 15. Remember that special enrollment periods (SEPs) may be approved throughout the year, based on consumers’ special circumstances. Marketplace enrollees who qualify for an SEP and want to change plans may need to select a new plan within the same plan category as their current plan, or wait until the next Open Enrollment period to change to a plan in a different category. Plan category limitations may apply when consumers:

• Currently have a Marketplace plan, • Experience certain SEP-qualifying events, and • Want to change from their current plan.

Most common SEP types, like a loss of qualifying coverage, permanent change in primary place of living, or gaining or becoming a dependent through birth, adoption, foster care, or court order, are subject to plan category limitations. Also, keep in mind that the Small Business Health Options Program (SHOP) is open all year and you may assist employers with the SHOP application and enrollment process during any month of the year.




Question You helped Magda enroll in a Marketplace QHP that became effective on January 1. Magda gets married in September, so she qualifies for a 60-day Marriage SEP. At that time, will she and her new spouse need to submit documents to the Marketplace to confirm their eligibility for the Marriage SEP?


Options

A. Yes. Magda and her new spouse will need to submit documentation to the Marketplace proving their marriage (such as a marriage license or certificate showing the date of the marriage).

B. No. Because Magda is are already enrolled in Marketplace coverage, she is not subject to the SEP pre-enrollment verification process.

C. Maybe. It depends on whether they want to switch plans or add one spouse to the other’s current QHP.

Correct Answer B

Positive Feedback You are right! Existing Marketplace enrollees who attest to SEP qualifying events are not subject to the SEPV process. New applicants (i.e., those who are not already enrolled in Marketplace coverage) who attest to certain types of SEP qualifying events are subject to SEPV. Eligible consumers must submit documents that confirm their SEP eligibility before the Marketplace finalizes their enrollment and they can make their first payment and start using their Marketplace coverage. Pre-enrollment verification has been implemented in connection with five SEP types:

• Loss of minimum essential coverage • Permanent move • Marriage • Gaining or becoming a dependent through adoption, placement for adoption, placement in foster care, or a child support or

other court order • Medicaid/CHIP coverage denial

You should help consumers understand what may make them eligible for an SEP and what they need to submit in terms of documentation to prove eligibility for an SEP. For more information, check out the following resources:

• “Special Enrollment Periods: An Overview for Marketplace Agents and Brokers” webinar slides • "Special Enrollment Period Pre-Enrollment Verification (SEPV): Review” webinar slides • How to Submit Documents

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Downloads/AB-SEP-Slides-Feb152018.pdfhttps://marketplace.cms.gov/technical-assistance-resources/sepv-review.pdfhttps://www.healthcare.gov/tips-and-troubleshooting/uploading-documents/



Page Text In this scenario, you learned that: • The annual Open Enrollment period for plan year 2021 is between November 1, 2020 and December 15, 2020.

Consumers must complete their plan selections by December 15 for their health coverage to become effective on January 1. There are no opportunities to make an Open Enrollment plan selection after December 15.

• SEPs are based on certain triggering events, which include gaining or becoming a dependent, loss of minimum essential coverage, or other exceptional circumstances.

• Most common SEP types, like a loss of qualifying coverage, permanent change in primary place of living, or gaining or becoming a dependent through birth, adoption, foster care, or court order, are subject to plan category limitations. This means if a current Marketplace enrollee wants to change plans during an SEP that he or she qualifies for, the consumer may need to select a new plan within the same plan category as his or her current plan, and wait until the next Open Enrollment if the consumer wants to change to a plan in a different category.

• The Marketplace uses a pre-enrollment verification process for new applicants (those who are not already enrolled in Marketplace coverage) to confirm their eligibility for the type of SEP they requested.

You have completed Scenario 4. Return to the Menu and proceed to Scenario 5. Alt Text An image of a calendar with days and dates showing in a table


Topic: 6 of 7: Scenario 5: Enrollment Pathways and Recording Your NPN on Applications Page: 1 of 6: Scenario 5: Narrative

Page Text

Enrollment Pathways and Recording Your NPN on Applications

Drew Chantel is meeting with an agent, Grace Rodriquez, whom he found using the “Find Local Help” tool available at HealthCare.gov, to obtain an eligibility determination and enroll in a QHP through the Marketplace. Consumers may use one of three pathways to complete the Marketplace application:

• The Marketplace Pathway (via HealthCare.gov) • The Classic Direct Enrollment Pathway • The Enhanced Direct Enrollment Pathway

Grace explains to Drew that all enrollment pathways use a dynamic, “smart” process that is based on the consumer’s circumstances, and generally only ask questions that are relevant to that consumer.

Alt Text A woman and a man sitting next to each other with the man looking at a day planner that the woman is holding

https://localhelp.healthcare.gov/https://www.healthcare.gov/




Question Which of the following is a feature of using the Classic Direct Enrollment Pathway?


Options

A. Registered agents and brokers affiliated with approved QHP issuers or web-brokers can log on to the issuer's or web-broker's (referred to as "partners") agent/broker portal, be redirected to an agent/broker landing page at HealthCare.gov, and enter information in the Marketplace application on behalf of the consumer.

B. An agent or broker has to sit "side-by-side" with the consumer to provide assistance; the consumer creates an account at HealthCare.gov, logs in to the site with a consumer account, and "drives" the process.

C. An agent or broker can only make changes to a consumer's application by conducting a three-way call with the consumer and the Marketplace Call Center.

Correct Answer A

Positive Feedback You are right! When using the Direct Enrollment Pathway, you can enter application information without having to sit side-by-side with the consumers you are helping. As part of the Direct Enrollment Pathway, you can also modify a consumer’s account after a plan selection has already been made (e.g., report a change in income or add a newborn under an SEP) without having to contact the Marketplace Call Center. You should contact your Classic Direct Enrollment provider to determine whether it supports changes to a consumer’s application outside of the Open Enrollment period, because not all do.




Question Which of the following is a feature of using the Enhanced Direct Enrollment Pathway?


Options

A. Registered agents and brokers affiliated with approved QHP issuers or web-brokers can log on to the issuer's or web-broker's agent/broker portal and have the ability to assist individuals in applying for and enrolling in Marketplace coverage directly from the QHP issuer’s or web-broker’s website without the redirect to and from the HealthCare.gov website.

B. Enhanced Direct Enrollment websites include payment functionality that allows the qualified individual to make the initial premium payment directly, or that allows the qualified individual to redirect to the applicable issuer.

C. An agent or broker may be able to view and download their clients’ Marketplace notices and assist their clients with year-round Marketplace functions.

Correct Answer A, B, C

Positive Feedback You are right! Approved partners offering the Enhanced Direct Enrollment Pathway may provide the full one-site experience for application, enrollment, and post-enrollment support on their own websites, without the redirect to and from the HealthCare.gov website. They may customize the Marketplace application, as long as they do not alter the substance of the Marketplace application, potentially simplifying and streamlining the questions that consumers are asked. Enhanced Direct Enrollment websites offer functionality to that allows the qualified individual to make the initial premium payment directly or redirects the qualified individual to the applicable issuer’s payment website for the initial premium payment. Enhanced Direct Enrollment Partners may also offer a range of client management functions for you to more easily assist consumers year-round. These capabilities may vary, but will generally include the ability to upload documents to adjudicate data matching issues and SEP verification issues, view the status of those issues, and download Marketplace notices, such as the Eligibility Determination Notice and Form 1095-A. You may find a QHP issuer or web-broker who is approved by the Centers for Medicare & Medicaid Services to offer the Enhanced Direct Enrollment Pathway via the Issuer and Direct Enrollment Partner Directory.

https://data.healthcare.gov/issuer-partner-lookuphttps://data.healthcare.gov/issuer-partner-lookup




Question Drew elects to use the Marketplace Pathway at HealthCare.gov, and has created his own Marketplace user account and is working with Grace at her office to complete the eligibility questions. Drew encounters a screen with the heading “Application Help" and the question "Is a professional helping you complete your application?” What should Grace direct Drew to select on his screen?


Options

A. Grace should ensure Drew selects the box for "Agent or Broker." This will produce a new set of fields, including one labeled “National Producer Number,” which is where Drew should enter Grace's name and NPN to record her assistance with his Marketplace application.

B. Grace should ask Drew to indicate, in any of the comment boxes he can type in, that he is getting help by including her name and state license number.

C. Grace should inform Drew that he does not need to make any entries on that screen.

Correct Answer A

Positive Feedback You are right! Grace should ensure Drew enters her name and NPN in the appropriate fields on this screen to indicate that she assisted him with this application. Both Grace's NPN and name are required to record her assistance on the Marketplace enrollment transaction. Remember, agents and brokers should ensure their clients enter this information correctly. A state license number is not a valid entry. For more information on recording your NPN on Marketplace applications, review this resource.

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Downloads/Instruct-Consumers-NPN-Marketplace.pdf




Question Drew changes jobs in the middle of the plan year and recalls that Grace told him he should report any changes to his income so that the Marketplace can adjust his APTC, if needed. Which of the following methods can Drew use to report the change while ensuring Grace’s NPN remains associated with his application?


Options

A. He can log in to his Marketplace account, select the application, and then select “Report a life change” from the menu on the left.

B. He can contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

C. He can ask Grace to conduct a three-way call between Grace, Drew, and the Marketplace Call Center.

D. He can ask Grace to log in to his Marketplace account to report his modified income.

Correct Answer A, B, C

Positive Feedback You are right! Grace’s NPN will remain associated with Drew’s application using any of these reporting methods, unless Drew actively removes or changes it, or requests that the Marketplace Call Center representative change the agent or broker of record on the application. Marketplace Call Center representatives will not remove an agent’s or broker’s NPN from an application unless requested by the consumer. Remember, consumers or their legally authorized representatives should not share their Marketplace usernames or passwords with third parties, including agents and brokers. Grace may not log in to HealthCare.gov as Drew to report his income change to the Marketplace.



Page Text In this scenario, you learned that: • Agents and brokers who use the Classic or Enhanced Direct Enrollment Pathway can enter application information without

having to sit side-by-side with the consumers they are helping. • Approved partners offering the Enhanced Direct Enrollment Pathway may provide the full one-site experience for

application, enrollment, and post-enrollment support on their own websites. This may include payment functionality that allows the qualified individual to make the initial premium payment directly or a link to a separate website for the qualified individual to make the initial premium payment, and client management functions that enable agents and brokers to more easily assist consumers year-round.

• Agents and brokers should ensure each application with which they assist includes their name and NPN to indicate that they assisted the consumer.

• Once an agent’s or broker’s NPN is recorded on an application, it stays with the application unless the consumer actively removes or changes it, or requests that the Marketplace Call Center Representative change the agent or broker of record on the application.

You have completed Scenario 5. Return to the Menu and proceed to the Key Points for this Review. Alt Text Image of a man and woman sitting at a desk; The woman is typing on a laptop and turns around to face the camera.


Topic: 7 of 7: Key Points Page: 1 of 2: Module Summary

Long Description Interactive graphic: A collage of icons representing module-specific concepts is displayed; three equally-sized rectangular buttons are shown from left to right across the bottom of the page. Each rectangular button has a label that corresponds to a key module topic or concept. When each button is selected, a pop-up box appears and displays accompanying text. Prompt text: Select each button and review the key points of this lesson. Eligibility

• To be eligible to obtain health insurance through the Marketplace, an individual must be a resident of the state where he or she will apply for coverage and enroll in a QHP; be a U.S. citizen or national, or a lawfully present non-citizen, and expect to remain so for the entire period coverage is sought; and not be incarcerated, other than incarceration pending the disposition of charges.

• QHP coverage through the Marketplace is generally not intended for individuals who are eligible for or enrolled in other types of minimum essential coverage.

• Consumers who meet specified criteria for projected annual household income, projected family size, and other eligibility criteria for the coverage year may qualify for financial assistance to help them afford health coverage purchased through the Marketplace. This assistance may include APTC to lower their monthly premium payments and income-based CSRs that reduce their out-of-pocket expenses.


• A person who is eligible to receive Medicaid or CHIP, or who is eligible for employer-sponsored coverage that is affordable and meets the minimum value standard, may purchase QHP coverage through a Marketplace, but is not eligible for financial help, such as APTC and income-based CSRs, to help pay for QHP coverage.

• Consumers who choose to apply some or all of the premium tax credit towards QHP premium costs on an advance basis must reconcile the allowed premium tax credit with the advance payments made on their behalf when they file their federal tax returns for the applicable plan year.

Data Matching Issues

• Consumers who are dually enrolled in both Marketplace coverage with APTC and/or income-based CSRs and in Medicaid or CHIP that qualifies as minimum essential coverage must either end their Marketplace coverage or update their Marketplace application to tell the Marketplace that they are not enrolled in Medicaid or CHIP by the deadline on the notice they receive; otherwise the Marketplace will end any APTC/CSRs being paid on their behalf, and their Marketplace coverage will continue without financial help.

• Agents and brokers can play an important role in helping consumers understand and take the required steps to resolve issues identified through the Marketplace data matching processes.

Enrollment

• The annual Open Enrollment period for plan year 2021 is between November 1, 2020 and December 15, 2020. Consumers must complete their plan selections by December 15 for their health coverage to become effective on January 1. There are no opportunities to make an Open Enrollment plan selection after December 15.

• Agents and brokers who use the Classic or Enhanced Direct Enrollment Pathway can enter application information without having to sit side-by-side with the consumers they are helping.

• Approved partners offering the Enhanced Direct Enrollment Pathway may provide the full one-site experience for application, enrollment, and post-enrollment support on their own websites. This may include payment functionality that allows the qualified individual to make the initial premium payment directly or a link to a separate website for the consumer to make the initial premium payment, and client management functions that enable agents and brokers to more easily assist consumers year-round.

• Agents and brokers should ensure each application with which they assist contains their name and NPN to indicate that they assisted the consumer.

• Once an agent’s or broker’s NPN is recorded on an application, it stays with the application unless the consumer actively removes or changes it, or requests that the Marketplace Call Center Representative change the agent or broker of record on the application.

SEPs

• SEPs are based on certain triggering events, which include gaining or becoming a dependent, loss of minimum essential coverage, or other exceptional circumstances.

• Most common SEP types, like a loss of qualifying coverage, permanent change in primary place of living, or gaining or becoming a dependent through birth, adoption, foster care, or court order, are subject to plan category limitations. This means if a current Marketplace enrollee wants to change plans during an SEP that he or she qualifies for, the consumer may need to select a new plan within the same plan category as his or her current plan, and wait until the next Open Enrollment if the consumer wants to change to a plan in a different category.

• The Marketplace uses a pre-enrollment verification process for new applicants (those who are not already enrolled in Marketplace coverage) to confirm their eligibility for the type of SEP they requested.


Page: 2 of 2: Module Completion

Page Text Congratulations! You have completed the Individual Marketplace Review for Returning Agents and Brokers. Alt Text A person standing on top of a mountain peak with arms outstretched

Topic: 1 of 7: Welcome to the Individual Marketplace Review for Returning Agents and BrokersPage: 1 of 4: Welcome to the Individual Marketplace Review for Returning Agents and BrokersLong Description

Page: 2 of 4: DisclaimerPage TextAlt Text

Page: 3 of 4: IntroductionPage TextAlt Text

Page: 4 of 4: Structure and NavigationPage TextAlt Text

Topic: 2 of 7: Scenario 1: Eligibility Criteria for Enrolling in a QHPPage: 1 of 6: Scenario 1: NarrativePage TextAlt Text

Page: 2 of 6: Scenario 1: Question 1PromptQuestionA. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be U.S. citizens or nationals, or lawfully present non-citizens, and expect to remain so for the entire period...B. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be U.S. citizens or nationals, or lawfully present non-citizens, and expect to remain so for the entire period...C. There are three criteria individuals must meet: (1) Be residents of the state where they will apply for coverage and enroll in a QHP; (2) Be employed for at least one year in the state where they will apply for coverage and enroll in a QHP; and (3)...Correct AnswerPositive Feedback

Page: 3 of 6: Scenario 1: Question 2PromptQuestionOptionsA. Her parents may both be eligible for Medicare since her dad is age 65 and her mom is under age 65 with a disability. You point out that the Marketplace does not determine eligibility for the Medicare program.B. Her parents should wait until several months after Malik's retirement to get their finances in order, and then follow up with you for assistance in seeking health coverage through the Marketplace.C. Her parents may be eligible to enroll in a Marketplace plan. You tell Shanika that you can assist her parents with eligibility, plan selection, and enrollment.Correct AnswerPositive Feedback

Page: 4 of 6: Scenario 1: Question 3PromptQuestionOptionsA. Tell them that they have no other options and should wait for the Florida Medicaid/CHIP office to contact them to complete the enrollment.B. Tell them that they may enroll Jada in a QHP available through the Marketplace, although it is likely not in their financial best interests to do so.C. Tell them that they should appeal the eligibility determination because this may expedite the Florida Medicaid/CHIP enrollment process.Correct AnswerPositive Feedback

Page: 5 of 6: Scenario 1: Question 4PromptQuestionOptionsA. You are not eligible to enroll in a QHP through the Marketplace since you are already receiving employer-sponsored coverage.B. Even though you are receiving employer-sponsored coverage, you may purchase a QHP through the Marketplace as long as you meet the eligibility criteria. However, you need to keep in mind that, if you decide to go that route, you will not be eligible...C. You should definitely purchase a QHP through the Marketplace since you will be eligible for APTC and income-based CSRs that will make your monthly payments and out-of-pocket expenses more affordable.Correct AnswerPositive Feedback

Page: 6 of 6: Scenario 1: CompletionPage TextAlt Text

Topic: 3 of 7: Scenario 2: Helping Consumers Resolve a Data Matching IssuePage: 1 of 6: Scenario 2: NarrativePage TextAlt Text

Page: 2 of 6: Scenario 2: Question 1PromptQuestionOptionsA. It means Maheen must provide an attestation indicating she is eligible to enroll in a Marketplace QHP; this attestation will resolve any data matching issues.B. It means Maheen cannot enroll in a QHP through the Marketplace; she must resolve her eligibility issue and then wait until the next Open Enrollment period to obtain health coverage through the Marketplace.C. It means Maheen may enroll in a QHP and receive APTC and income-based CSRs through the Marketplace, but she must take action to resolve the issue between her Marketplace application and the information contained in the approved electronic sources t...Correct AnswerPositive Feedback

Page: 3 of 6: Scenario 2: Question 2PromptQuestionOptionsA. He should encourage Maheen to submit the requested information as soon as possible, preferably by uploading the requested documents through her HealthCare.gov account.B. He should emphasize that if Maheen does not send the requested documentation by the deadline, she may lose eligibility for health coverage through the Marketplace.C. He should direct Maheen to start over with a new Marketplace application and answer the immigration status questions differently to see if she gets a different eligibility determination result.Correct AnswerPositive Feedback

Page: 4 of 6: Scenario 2: Question 3 NarrativePage TextAlt Text

Page: 5 of 6: Scenario 2: Question 3PromptQuestionOptionsA. She should take no action in response to this notice.B. She should immediately contact the applicable Marketplace to end her Marketplace coverage with APTC.C. She should contact the North Carolina state Medicaid agency to end her Medicaid coverage and keep her Marketplace coverage with APTC and income-based CSRs.Correct AnswerPositive Feedback


Topic: 4 of 7: Scenario 3: Eligibility for Financial Assistance through the MarketplacePage: 1 of 5: Scenario 3: NarrativePage TextAlt Text

Page: 2 of 5: Scenario 3: Question 1PromptQuestionOptionsA. Either Roger or James must be eligible to enroll in other minimum essential coverage, such as employer-sponsored coverage or a government-sponsored program.B. They must have been enrolled in a Marketplace QHP for the previous plan year; otherwise, they may claim the tax credit on their federal income tax return, but they may not qualify to receive the premium tax credit in advance.C. They must have an annual household income between 100% and 400% of the federal poverty level (FPL).Correct AnswerPositive Feedback

Page: 3 of 5: Scenario 3: Question 2PromptQuestionOptionsA. They should enroll in a Bronze plan through the Marketplace.B. They should enroll in a Silver plan through the Marketplace.C. They should enroll in a catastrophic plan through the Marketplace.Correct AnswerPositive FeedbackPromptQuestionOptionsA. If the amount of the allowed premium tax credit is more than the amount the Hansens chose to have paid directly to the issuer, or received as APTC (i.e., a net premium tax credit), the difference (called "net premium tax credit") will increase the ...B. If the amount of the allowed premium tax credit is less than the APTC, excess APTC was paid on the Hansens’ behalf. The Hansens must enter the APTC amount on their return and will be required to repay all or a portion of it when filing the tax retu...C. If the Hansens do not file a federal tax return for the year in which APTC were paid on their behalf, the Marketplace will discontinue their future eligibility for APTC and CSRs to help pay for their Marketplace health insurance coverage.Correct AnswerPositive Feedback


Topic: 5 of 7: Scenario 4: Open Enrollment Period and Special Enrollment PeriodsPage: 1 of 4: Scenario 4: NarrativePage TextAlt Text

Page: 2 of 4: Scenario 4: Question 1PromptQuestionOptionsA. October 1, 2020 through January 31, 2021B. November 1, 2020 through December 15, 2020C. November 15, 2020 through February 15, 2021D. November 1, 2020 through January 31, 2021Correct AnswerPositive Feedback

Page: 3 of 4: Scenario 4: Question 2PromptQuestionOptionsA. Yes. Magda and her new spouse will need to submit documentation to the Marketplace proving their marriage (such as a marriage license or certificate showing the date of the marriage).B. No. Because Magda is are already enrolled in Marketplace coverage, she is not subject to the SEP pre-enrollment verification process.C. Maybe. It depends on whether they want to switch plans or add one spouse to the other’s current QHP.Correct AnswerPositive Feedback


Topic: 6 of 7: Scenario 5: Enrollment Pathways and Recording Your NPN on ApplicationsPage: 1 of 6: Scenario 5: NarrativeAlt Text

Page: 2 of 6: Scenario 5: Question 1PromptQuestionOptionsA. Registered agents and brokers affiliated with approved QHP issuers or web-brokers can log on to the issuer's or web-broker's (referred to as "partners") agent/broker portal, be redirected to an agent/broker landing page at HealthCare.gov, and enter...B. An agent or broker has to sit "side-by-side" with the consumer to provide assistance; the consumer creates an account at HealthCare.gov, logs in to the site with a consumer account, and "drives" the process.C. An agent or broker can only make changes to a consumer's application by conducting a three-way call with the consumer and the Marketplace Call Center.Correct AnswerPositive Feedback

Page: 3 of 6: Scenario 5: Question 2PromptQuestionOptionsA. Registered agents and brokers affiliated with approved QHP issuers or web-brokers can log on to the issuer's or web-broker's agent/broker portal and have the ability to assist individuals in applying for and enrolling in Marketplace coverage direct...B. Enhanced Direct Enrollment websites include payment functionality that allows the qualified individual to make the initial premium payment directly, or that allows the qualified individual to redirect to the applicable issuer.C. An agent or broker may be able to view and download their clients’ Marketplace notices and assist their clients with year-round Marketplace functions.Correct AnswerPositive Feedback

Page: 4 of 6: Scenario 5: Question 3PromptQuestionOptionsA. Grace should ensure Drew selects the box for "Agent or Broker." This will produce a new set of fields, including one labeled “National Producer Number,” which is where Drew should enter Grace's name and NPN to record her assistance with his Marketp...B. Grace should ask Drew to indicate, in any of the comment boxes he can type in, that he is getting help by including her name and state license number.C. Grace should inform Drew that he does not need to make any entries on that screen.Correct AnswerPositive Feedback

Page: 5 of 6: Scenario 5: Question 4PromptQuestionOptionsA. He can log in to his Marketplace account, select the application, and then select “Report a life change” from the menu on the left.B. He can contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).C. He can ask Grace to conduct a three-way call between Grace, Drew, and the Marketplace Call Center.D. He can ask Grace to log in to his Marketplace account to report his modified income.Correct AnswerPositive Feedback


Topic: 7 of 7: Key PointsPage: 1 of 2: Module SummaryLong Description

Page: 2 of 2: Module CompletionPage TextAlt Text

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