Broker Professional Training Open Enrollment 2019

Introductions

Agenda Broker Portal Functionality Tango Process (AOR) Consumer Portal System Related Enhancements Policy Changes Resources Topics that will be covered in this presentation.

Broker Portal Functionality Symantec /Credential Login Broker Portal Walkthrough (looking for client lists) Request for client list reports & client maintenance

The professional portal will allow the broker to help their clients report any necessary changes to Access Health CT for their application. Reporting changes in this manner will be reflected to the client the next time they access their consumer portal account.

1 2 3 You will arrive at the Login screen. Type in your Username. Type in your Password or Temporary Password. 2 Click on Login. 3

1 Alt 1 2 Alt 2 You will arrive at the Security Code screen. Type in your security code from the Symantec app. Alternative: If your Symantec app is not available, request a system generated Security Code by selecting one of the buttons above: Email SMS/Text Msg Phone Call 2 Alt 2 Click “Validate” Alternative: Click “Get Password” then follow the previous Symantec steps.

1 2 You will arrive at the Change Password screen. You will be prompted to change your password, so enter the Old Password or the Temporary Password and a New Password (twice). 1 2 Then click “submit”.

Client Lists

Professional Portal Landing Page : Broker 1 Click on “My Clients” to display consumers list. November 1, 2017

Broker Client List In the first column, the client names in blue have completed the “Tango Process” with the broker. Those in black have not completed the process. You can select a connected client by clicking on their name.

Client’s Account: Home Page Broker Broker is acting on behalf of the client. The Broker can complete an application or “Report a Change” on client’s behalf.

Client List Reports & Maintenance Maintain an active list of clients Quarterly check-ins during the year Advise the clients to contact broker directly about changes BEFORE calling the call center.

Tango Process (AOR) 3- Step Process Creating Broker-Client Connection AOR- Agent of Record 72-Hour “Linking Opportunity”

Step 2: Broker Action Step 3: Client Action Search for Broker in the area Send request to assistance Step 3: Client Action Accepts requests System Prompt for Authorization Confirms connection Authorizes Broker to view their account

What’s Changed? 72 Hour “Linking Opportunity”

Consumer Portal Household Income Employer Sponsored Insurance (ESI) Tax Information Special Enrollment Period (SEP) Failure to Reconcile (FTR) VCL

Employer Sponsored Insurance Before “Shopping” An employee that is eligible for Affordable, Minimum Value coverage through their employer is not eligible for APTC’s. The questions about employer-sponsored insurance are mandatory. “Will any member of this household be eligible for health coverage?” If “Yes” The 10 essential benefit services must be cover under the Affordable Care Act.   The employer name, address, etc. Who in the household is offered the coverage; Cost of premium for employee ONLY. The employee’s status and whether the plan meets Minimum Value.

Household Income Accurate reported annual income Yearly vs Monthly Has your income change within the year? If income is entered as yearly, the system will calculate the monthly amount. If the applicant is not certain what to report for their income or what should be deducted, ask them to consult their accountant/tax adviser. Household income types

There are 8 Options to choose from for indicating a Tax Filing Status Tax Information There are 8 Options to choose from for indicating a Tax Filing Status The member needs to check off if they paid taxes for the prior tax year. The member needs to indicate prior year’s tax status for each household member. Check if the household has reconciled their received APTC’s on their Federal taxes. The member needs to enter this year’s expected tax status for their household. If you received tax credits in 2017 and you do not file your tax return with IRS Form 8962 to reconcile your tax credits, you will not be able to receive tax credits in future years until you file your 2017 tax return.

Failure to Reconcile By law, consumers who receive APTC’s are required to reconcile those advanced payments. In “Individual Details” section of the application, the client confirms to having reconciled their APTCs for past years. The process of reconciliation has three parts: 1. Receive payment of APTC’s during the coverage year. 2. Receive form 1095-A which shows all premiums paid tax credits received. 3. Use form 1095-A to complete Form 8962 with tax filing. 1. 2. 3.

Special Enrollment Period A SEP is a period of time outside of Open Enrollment in which qualified individuals can obtain coverage when they have experienced a Qualifying Live Event (QLE) If the individual fails to verify their qualifying life event within 30 days of enrolling into a plan, they will be disenrolled. QLE is a change in circumstance that may impact an individual’s or dependent’s eligibility for coverage or financial help on and off the Exchange. SEPs could occur during Open Enrollment. For more information: Visit http://learn.accesshealthct.com/special/

VCL Types of Verification Required What is the 90-Day ROP? Citizenship Identity Immigration Status Veteran Status Income Self-Employment Incarceration American Indian and Alaska Native Status Residency Employer-sponsored Insurance What is the 90-Day ROP? ROP = Reasonable Opportunity Period This process is often referred to as Verification Checklist (VCL) When a consumer attests to certain information and that information cannot be confirmed by electronic data sources, a 90-day ROP triggers, allowing the consumer to have continuous coverage while the consumer proves or verifies his or her attestations. For additional detailed information regarding acceptable documents for verification, please refer to module “The Verification Process for Consumer Portal”.

System Related Enhancements Multiple Initial Applications (MIA) Improved User Inbox for Consumer Prevent Disenrollment Errors During Open Enrollment Preventing Concurrent Users on the Same Application Consumer Account Locked

Consumer Account Locked A consumer can log in to an account that a worker is currently working in, but will see a message displayed that informs them that a Customer Service Rep is currently in the application. They will not be able to make a change until the worker leaves the application.

Policy Changes Alimony Pregnancy QLE Market Stabilization COBRA Short Term Limited Duration Insurance Plans

Policy Changes – Plan Year 2019 MAGI Calculation (the Tax Cuts & Jobs Act 2017) Disclaimer: the below discussed change does not go into effect until 1/1/2019. Calculations of MAGI during OE (Nov. 1-Dec 15) will not change. For Divorce Decrees finalized after 1/1/2019, Alimony will no longer be deducted or counted when calculating MAGI What if I’m in the middle of a divorce during OE? What if I’m already divorced during OE, but I have an alimony arrangement? What if I think I’m going to get a divorce during Plan year 2019?

Policy Changes – Plan Year 2019 Pregnancy as a Qualifying Life Event beginning 1/1/2019 Individuals who attest to being pregnant will be allowed a Special Enrollment Period beginning in 2019. Pregnant individuals must have the pregnancy certified by a licensed physician Certification must occur within 30 days of commencement of the pregnancy Challenges This QLE does not line up with our other QLE timelines (usually 60 days, this is only 30 days)

Policy Changes – Plan Year 2019 Carrier Premium Payment Policy option (as adopted under the Market Stabilization Rule of 2017) Enrollees terminated for non-payment of premium may be required to pay past due premium before effectuating. Carriers may only look back as far as Sept. 2018 to collect past due premium (they will have a look-back period of up to 12 months by this time next year) AHCT will work with consumers who call to enroll to be sure they understand that additional payments may be required.

Policy Changes – Plan Year 2019 Short-Term, Limited Duration Insurance Plans CT Insurance Dept. Bulletin HC-121 requires all short-term limited duration plans to: Cover all 10 Essential Health Benefits Provide coverage with no Lifetime or Annual Dollar Limits Include coverage for pre-existing conditions for policies with a duration of longer than 6 months. Based on these rules, STLDI plans offered currently in the market are not compliant for 1/1/2019. AHCT will monitor carriers who file STLDI plans.

Policy Changes – Plan Year 2019

Policy Changes – Plan Year 2019

Plan Browsing & Decision Support

PCP Selection Screens Passage Plan Requirement Easy access Multiple filters: provider, language, zip code, specialty, etc.

USEFUL RESOURCES

Check List Broker Client Primary Applicant Name & Address Indicate Medical Emergency Comprehensive Summary Client issue (Please include any important dates, payment info, or details of previous consumer attempts to resolve the issue) Broker Name & Phone number(s) Broker CT License number Primary Applicant Name & Address Primary Applicant Phone Number(s) Date of Birth(s) Social Security Number(s) (Mandatory) Email Address Last Known Application ID number Applicant User ID (If Applicable) Name of ALL Covered Members (Specify coverage type for each member QHP/Medicaid) QHP Carrier Name & Subsidy amount Full QHP Name & Coverage Effective Date Broker Client

QUESTIONS SUGGESTIONS