March Enrollment Knowledge Transfer

Enrollment Knowledge Transfer Purpose: Provide updates and answer questions on the Healthplanfinder enrollment process Scope: Enrollment into qualified health plans Occurrence: Monthly; the second Thursday 12:15- 12:45

Resources Navigators: Contact your Lead Organization Producers: E-mail producer@wahbexchange.org Others: Customer Support Center 855-923-4633

How to request a 1095-A Correction Submit a correction request: Correction Request web form: https://www.wahbexchange.org/current-customers/your- 1095-a-statement/ Washington Healthplanfinder Customer Support Center 855-923-4633

Always Voluntarily Terminate Never advise applicants to terminate via non- payment Non payment rules can result in the missed payment being owed to the carrier when they sign back up for coverage Or they may owe the IRS the 1 month of payment they did not pay the carrier, if APTC is claimed

Medicare and Apple Health The Health Care Authority will make this transition automatically The applicant should still report this change to Healthplanfinder

Medicare and Qualified Health Plans New Enrollees: Regulations do not allow an issuer to sell duplicative coverage to a Medicare recipient Existing Enrollees: Individuals eligible for other coverage are not eligible for tax credits or cost- sharing reductions

Medicare and Qualified Health Plans An applicant must take action! Applicants are required to report a change in circumstances

Medicare and Qualified Health Plans Never advise an applicant to delay or opt out of Medicare to keep their tax credits or CSR subsidy This may have negative impacts for an applicant for the rest of their time in Medicare If an applicant wants to keep their QHP coverage with Medicare, this is completed via a ticket

Scenarios: PA Only Scenario 1: PA enrolled in coverage, wants to transition out of both QHP and QDP coverage Cancel coverage button, both QDP and QHP Scenario 2: PA enrolled in coverage, wants to transition out of QHP and keep QDP only Cancel coverage button, only QHP

Scenarios: PA and Spouse Scenario 3: PA and Spouse enrolled in coverage. One going on to Medicare. Medicare-eligible enrollee wants to transition out of QHP and QDP coverage Report a change to that person not seeking Scenario 4: PA and Spouse enrolled in coverage. One going on Medicare and both want to keep QHP Request via ZD ticket Scenario 5: PA and Spouse enrolled in coverage. One going on Medicare and both want to keep QDP

Resources Statewide Health Insurance Benefits Advisors (SHIBA) https://www.insurance.wa.gov/about-shiba-services Call: 800-562-6900 TDD: 360-586-0241