Navigating DCHealthLink Enrollment ChallengesBy Julie Gallion, PHR

Deadlines• Issue: The Exchange has VERY tight and specific

deadlines.▫ In the Exchange, if you miss the deadline, you miss

the deadline... PERIOD. No changes can be made after that date has passed.

▫Note: The exception is if there is a technical issue on the Exchange's side that you have documented. If you have documentation, you might get a day or two extension.

• Solution: Submit your application early.▫Create a log-in ASAP to do your research ahead of

time. (Pricing may change slightly between now and October 1.

Deadlines for January 1, 2015 Effective Date•October 1, 2014 – First day employers can

submit applications (I recommend that you submit your application on this date to leave plenty of time for issues to be resolved)

•November 26, 2014 – Last day for the employer to submit the employer application

•December 10, 2014 – Last day for employees to complete enrollment

Technology• Issue: The Exchange

will not work on Internet Explorer

• Solution: Use Google Chrome or Mozilla Firefox

Data Entry• Issue: Any inconsistencies with entries of names, dates

or numbers can throw the system into a tailspin.▫ The employer begins by setting up a username, which

requires the representative’s full name AND a username and password. The employer must be consistent throughout the process with the full name of this representative.

• Solution: Copy or write down EVERYTHING you enter and print screen shots of every screen. ▫ You likely will not be able to get back into previous

screens to figure out what you initially typed when completing the forms.

▫ The customer service folks at the Exchange can't help if they don't have screen shots.

Employer Application• Issue: There are three separate steps just to complete the

employer application.1. Create a login. This simply asks for the organization

representative’s full name, a username and password. Completing this step enables you to search the plans and pricing.

2. Complete the application. Enter the employer name  and EIN as well as other employer information. You can fill out this part of the application to access additional information and enter employee data without submitting it.

3. Sign the application. Funny story: It took me a week to actually complete submission of the application because the system would not accept my name as it was entered in the signature column and the Exchange did not know why.

• Note: Submitting an application does not obligate the employer to do anything. However, it is very difficult to change an open enrollment date so make sure you enter the accurate information.

Employer Application Cont’d

•Solution: Start early.▫Read every screen thoroughly before

moving on▫Read the SHOP Employer documents ahead

of time: Employer Deadlines Small Business Guide Employee Instructions Managing your account Census import

Data Entry Part 2: Employee Data• Issue: Employees must enroll themselves online.

▫ Each employee will need to create an account, enter their personal data, link their account to the employer account, choose a plan and "sign" the application through the online portal.

▫ Another funny story: When I worked through this with a client, none of the 6 employees we attempted to enroll were actually able to complete this process. The only possible reason given is that something the employee entered did not match something I entered to identify the employee as one of ours.

• Solution: Advanced planning.▫ Make sure the employee data you have (legal name, SS#, date of birth) is

accurate and as it appears on the employee’s Social Security card. ▫ To avoid typos, import the employee data via a census upload rather than

typing it in manually. Here is a link to the census template Census import▫ Before the import, make sure the census is 100% accurate by having

several pairs of eyes review it.▫ Start open enrollment as soon as possible, November 1 for a January 1

effective date.

Employee Cost Sharing• Issue: The Exchange provides limited cost sharing options.

▫ See full explanation of cost sharing challenges in my previous post.

▫ Only 2 available options in the Exchange:1. Charging employees a certain percentage for a reference plan (see

full explanation of reference plan in previous post);2. Charging employees a certain percentage for their families within

a reference plan.▫ You CANNOT indicate a different charge or percentage based on

the plan choice, or charge employees a specific dollar amount, or pay a certain dollar amount toward family coverage.

▫ In real life, when it comes to what you actually deduct from pay, you can alter your cost sharing arrangement(making it less costly for the employee) but when an employee enrolls online, s/he will only see the amount according to the percentage the employer entered.

Employee Cost Sharing Cont’d• Solution: Unfortunately, there isn’t one yet.

▫ If you plan to alter the amount you actually charge employees from the percentage entered, you'll need to find a way to make sure employees understand that the actual pricing will differ from what they see on the Exchange website.

▫ Know that there could be upwards of 50+ options on the exchange and that each option is priced based on the age of each individual employee, so expanding cost-sharing outside of what the Exchange allows may be a challenge.

▫ If you decide to provide cost sharing beyond the straight percentage allowed within the Exchange, it is absolutely imperative that you communicate your strategy to employees so that they understand their choices.

Need more help?

Call or email Julie Gallion at 202-785-2060 (jgallion@nonprofithr.com) for support with Exchange enrollment or general benefits questions.