step 5 application and eligibility...

How it looks on the

Tracking Sheet

Step 5: Application and Eligibility Letter

How it

looks on

the

Resource

Page

If you have been following:

The STEPS…

You have the info needed to complete

the application

Step 5: Application

the application

But, what if you’d skipped steps and

gone right to the application?

Ernest sits down with you….

And says “I already did an application last year and I’m just renewing my plan for 2018.”

VERY tempting to skip the steps and go immediately into the application.immediately into the application.

Why not, eh?

The info’s already in there!

Ernest got married

Ernest got a raise

Ernest started a new job

Ernest and his spouse had triplets

Ernest was offered coverage through his job

Ernest’s spouse was offered coverage through his job

Ernest’s in-laws moved in and are being supported by Ernest

Ernest is receiving additional income that might be taxable Ernest is receiving additional income that might be taxable

Ernest doesn’t know the date of birth of his triplets or spouse

Ernest moved out of Travis County last year

Ernest’s spouse has stopped working and now is self employed

When a consumer says:

“just renewing” or “everything’s the same”

REVIEW the steps QUICKLY

Step 1: Need consent/survey every year! “I’ll just look that over and enter it!”

Step 2: Offer of Coverage? “Where are you working? Still self employed? No problem!”

Step 3: “Any changes to your tax household? Still single? How old are you? Immigration Status? Are you currently insured? Any medical needs we’ll want to consider? Are Status? Are you currently insured? Any medical needs we’ll want to consider? Are you a tobacco user? No problem!”

Step 4: “Expecting an income similar to last year? Let’s do a quick estimate for 2018!

Earning 12 per hour and working 35 hours a week with about two weeks off per year? Expecting around $21,840 for 2018? No problem!”

Now: Ready to Complete Step 5

Welcome to the Health Insurance Marketplace!

healthcare.gov

Accessing an Account

Do you already have an account on healthcare.gov?

YES NO

Create new accountAccess existing account

Detailed instructions on Resource Page.

Do you know your log in information for that account?

Breaking into an Existent Account

PLEASE don’t send a consumer away for

log in info

Avoid: “Forgot Username/Password” LinkAvoid: “Forgot Username/Password” Link

Why? If you are working with a consumer who

can’t access to their account, we’ve likely

already tried this step at intake.

Resource Page Resource!

Ask consumer to create password they can remember.

Need upper & lowercase & number.

Ask consumer for email they can access NOW.

Ask consumer to open email BEFORE you create acct.

If no email or can’t access, use “ict” email address.

Enter name as it appears on official document.

Security Q: Want answers = FACTS that won’t change

Avoid dates: too hard to remember format

Start with NAME questions:

Oldest niece? Favorite pet?

Favorite childhood friend?

City where mother was born?

Need upper & lowercase & number.

Write

VERY VERY

clearly!

Look for email from notices@healthcare.govWill arrive almost instantaneously.

General Application Tips

Remember: You have all the big picture

household and income info already

• Question about an Application Question?• Question about an Application Question?– Ask a manager. Don’t guess or assume.

• Summarize– Rather than reading verbatim.

• Pass the keyboard rather than switching seats.– Consumer signs twice. You do everything else.

Click on GREEN

3-4 Identity Verification Questions

432 area code

= OdessaSome answers will always be

“NONE OF THE ABOVE”

“You agree that Marketplace can check your

Your identity has been verified

“You agree that Marketplace can check your

information against other federal agencies and

credit reporting agency.”

Who is in your TAX HOUSEHOLD?

USE SINGLEif head of household,

victim of abandonment,

or domestic violenceor domestic violence

Is your income less than 400% FPL?

Do you want to apply for subsidies?

Completing an Application for

someone ineligible for subsidies (offered

coverage, close or over 400%) ?

Answering no means a shorter application!

If JUST COBRA,

answer NO.

VERY IMPORTANT

BOXES!

YOUR First Name

TXCACB###Foundation CommunitiesCertified Application Counselor

Only place need to enter FULL CAC #

Last CAC to touch application

MUST enter their information

YOUR Last Name

Enter your information like this:

INDIVIDUALS APPLYING: INCLUDEINDIVIDUALS APPLYING: INCLUDE

IF NOT APPLYING: SKIP

Can be SKIPPED to save time

Job

Social Security

Capital gains

Farming/fishing

Rental or royalty

Pension

List of Income Options:

Social Security

Alimony

Scholarship

Self-employment

Farming/fishing

Other income

Unemployment

Investment

Pension

Retirement

Cash support

Note how similar this list is to what’s on the

income section of the tracking sheet!

JOB: How often does Mark get this amount?

One time only

Weekly

Every 2 weeks

Twice a month

Monthly

Yearly

USE MONTHLY

OR YEARLY

AVOID: One time only,

weekly, every 2 weeks

or twice a month.

Self-employment: Enter Income after expenses.

Application requires self-employment entered monthly.

Enter 1/12th of profit estimate for 2017

Anticipated Future Job Income:

Enter as Self-employment

Mark 2018

Always answer NO to deductions question.

Skip Medicaid Questions

Physical disability/mental health limits ability to work?

Need help with daily activities?

Need help paying medical bills from last 3 months?

Answer NO if enrolled in ENDING coverage, such as a

MP plan ending 12/31/2017

ONLY ANSWER YES IF: consumer has a letter

showing denial WITHOUT compliance issues

Special Enrollment Questions: Skip

Application Quiz1)

Answer YES Or NO for the following:

a) Becca, a single citizen earning about $15,000

b) Lyle, a single citizen earning $9,000

c) Jordan, single citizen earning $120,000

2)

Answer Yes or No, if Arianna is Self EmployedAnswer Yes or No, if Arianna is Self Employed

3)

Application Quiz Continued

4) What is the most effective, efficient way to answer the following questions?

ONLY 2 items to check on Summary:

1 - All names spelled correctly.

2 - Address is correct (with Apt or Trailer #).

End of Application

Questions

Pass the keyboard to the consumer so they can sign.

The consumer MUST sign themselves. But, they can sign

however they wish.

TEMPORARY ELIGIBILITY = Must submit info within

90 days to KEEP credits & insurance for rest of year

Note: Only print first 1-4 pages through: “What

Should I Do Next” Section!

Step 5 on

Tracking Form

Monthly Premium Tax Credit

If required to verify income,

always need to support this total amount.

12/30

14,400

345How to

Fill Out

Step 5:

12/3012/3012/3012/30

Complete Step 5

the tracking sheet

using Jessica and Richard’s

eligibility letter

Let’s Practice!

Complete the Step 5 (and don’t

forget Step 6 where necessary!)

Review Different

Eligibility Letters

• Exemption• Exemption

• Is this the answer you expected?

• Need to file taxes

• How would we enter these outcomes on

the tracking sheet?

Always capture required

uploads while reviewing

eligibility letter!

If NOTHING is requested

ONE STEP UPLOADS occur in Step 7.

Let the consumer know proof is

being requested, but deal with

enrollment first

What’s with all this blank space?