CO
MM
UN
ITY
H
EALT
H C
HO
ICE
2020
BRO
KER
TRA
ININ
G
Hea
lth In
sura
nce
Mar
ketp
lace
Hou
seke
epin
g
• B
e re
spec
tful o
f you
r pee
rs: P
leas
e m
ake
sure
to m
ute
your
pho
ne a
nd h
old
ques
tions
to th
e en
d of
the
pres
enta
tion
• P
rese
ntat
ion
will
be
sent
to a
ll ag
ents
via
em
ail a
nd w
ill
also
be
post
ed o
n th
e ag
ent p
orta
l
• 20
20 a
genc
y/ag
ent p
aper
wor
k is
ava
ilabl
e fo
r non
-ap
poin
ted
agen
ts/a
genc
ies,
but
sho
uld
be c
ompl
eted
and
su
bmitt
ed im
med
iate
ly to
ens
ure
timel
y ap
poin
tmen
t (yo
u w
ill n
ot b
e pa
id o
n an
y bu
sine
ss s
old
prio
r to
appo
intm
ent
conf
irmat
ion)
• P
leas
e be
sur
e to
pro
vide
any
upd
ates
to y
our
W9/
Add
ress
es/C
onta
ct In
form
atio
n, i.
e. p
hone
, em
ail,
etc.
2
Agen
da
• B
roke
r App
oint
men
t & A
gree
men
t Rem
inde
rs
• S
ofth
eon
Bill
ing
and
Enr
ollm
ent S
yste
m
• 20
20 P
lans
, Ben
efits
& R
ates
•
Ser
vice
Are
a an
d N
etw
ork
• En
rollm
ent &
SEP
’s
• N
ext S
teps
•
Q&
A
3
Bro
ker A
ppoi
ntm
ent &
Agr
eem
ent
Rem
inde
rs
4
Bro
ker A
ppoi
ntm
ent
• M
ust c
ompl
ete
annu
al C
MS
cer
tific
atio
n fo
r Ind
ivid
ual
Mar
ketp
lace
• M
ust c
ompl
ete
annu
al C
omm
unity
trai
ning
and
com
plet
e a
quiz
with
a s
core
of 8
0% o
r hig
her
• A
ll ag
ents
mus
t com
plet
e an
d re
turn
a tr
aini
ng a
ttest
atio
n
• M
ust h
ave
an a
ctiv
e TD
I lic
ense
• M
ust h
old
an a
ctiv
e E
rror
s &
Om
issi
ons
Pol
icy.
• M
ust s
uppl
y a
W9
that
cor
resp
onds
to ta
x fil
ing
addr
ess
5
Bro
ker A
gree
men
t Rem
inde
rs
• Ag
ent/A
genc
y m
ust k
eep
reco
rds
for a
per
iod
of 1
0 ye
ars
as re
quire
d by
CM
S
• Ag
ent/A
genc
y m
ust c
ompl
y w
ith a
ll ap
plic
able
sta
te a
nd fe
dera
l law
s re
gard
ing
solic
itatio
n of
bus
ines
s in
clud
ing
all
stat
e an
d fe
dera
l con
fiden
tialit
y co
nflic
t of i
nter
est
law
s, ru
les
and
regu
latio
ns
• M
ust c
ompl
y w
ith a
ll St
ate
and
Fede
ral r
egul
ator
y re
quire
men
ts in
clud
ing
all
disc
laim
ers
on e
nrol
lmen
t mat
eria
ls a
nd w
ebsi
tes:
•
Sam
ple
Lang
uage
: “A
ttent
ion:
Thi
s w
ebsi
te is
ope
rate
d by
[Nam
e of
Com
pany
] and
is n
ot th
e H
ealth
In
sura
nce
Mar
ketp
lace
web
site
. In
offe
ring
this
web
site
, [N
ame
of C
ompa
ny] i
s re
quire
d to
co
mpl
y w
ith a
ll ap
plic
able
fede
ral l
aw, i
nclu
ding
the
stan
dard
s es
tabl
ishe
d un
der 4
5 C
.F.R
. 15
5.22
0(c)
and
(d) a
nd s
tand
ards
est
ablis
hed
unde
r 45
C.F
.R. 1
55.2
60 to
pro
tect
the
priv
acy
and
secu
rity
of p
erso
nally
iden
tifia
ble
info
rmat
ion.
Thi
s w
ebsi
te m
ay n
ot d
ispl
ay a
ll da
ta o
n Q
ualif
ied
Hea
lth P
lans
bei
ng o
ffere
d in
you
r sta
te th
roug
h th
e H
ealth
Insu
ranc
e M
arke
tpla
ce w
ebsi
te. T
o se
e al
l ava
ilabl
e da
ta o
n Q
ualif
ied
Hea
lth P
lan
optio
ns I
in y
our
stat
e, g
o to
Hea
lth In
sura
nce
Mar
ketp
lace
web
site
at H
ealth
Car
e.go
v.”
• Li
nk: h
ttps:
//ww
w.cm
s.go
v/C
CIIO
/Pro
gram
s-an
d-In
itiat
ives
/Hea
lth-In
sura
nce-
Mar
ketp
lace
s/D
ownl
oads
/Gui
danc
e-W
eb-b
roke
rs-D
ispl
ayin
g-D
iscl
aim
ers.
6
Bro
ker A
gree
men
t and
C
ompe
nsat
ion
for 2
020
• P
ost T
rain
ing,
all
agen
ts w
ill c
ompl
ete
the
2020
Ben
efit
quiz
and
sig
n an
d da
te th
e 20
20
Trai
ning
Com
plet
ion
Atte
stat
ion.
You
mus
t sub
mit
both
the
quiz
AN
D a
ttest
atio
n ba
ck to
C
omm
unity
Hea
lth C
hoic
e @
Age
nt.C
rede
ntia
ling@
Com
mun
ityC
ares
.com
• 20
20 C
ompe
nsat
ion
– C
omm
unity
has
app
rove
d a
20%
INC
RE
AS
E in
Bro
ker
com
mis
sion
s be
ginn
ing
Janu
ary
1, 2
020.
Bro
ker
will
now
ear
n $1
8 pe
r m
embe
r pe
r m
onth
for
new
or
rene
win
g bu
sine
ss o
n al
l pla
ns
• C
omm
issi
on s
tate
men
ts a
re g
ener
ated
on
the
3rd F
riday
of t
he m
onth
• C
omm
issi
ons
are
paya
ble
on th
e 4th
Frid
ay o
f the
mon
th
• C
omm
issi
on D
irect
Dep
osit
is d
one
thro
ugh
EFT.
Thi
s re
quire
s se
t up
thro
ugh
our
third
-par
ty v
endo
r, FI
S In
tegr
ated
Pay
able
s an
d co
mes
in th
e fo
rm o
f an
emai
led
notif
icat
ion
dire
ct fr
om F
IS In
tegr
ated
Pay
able
s (n
ot C
omm
unity
). Fo
r mor
e in
form
atio
n pl
ease
con
tact
Age
nt.C
omm
issi
ons@
Com
mun
ityC
ares
.com
• Ag
ent o
f Rec
ord
(AO
R )
chan
ges
are
effe
ctiv
e th
e fir
st o
f the
follo
win
g m
onth
or a
t the
di
scre
tion
of C
omm
unity
Hea
lth C
hoic
e, In
c.
7
Boo
k of
Bus
ines
s Tr
ansf
ers
• P
urch
asin
g/Tr
ansf
errin
g bo
oks
of b
usin
ess
due
to d
eath
, ret
irem
ent,
etc.
•
On-
Exc
hang
e bu
sine
ss
• B
ulk
trans
fer p
roce
ss n
ot c
urre
ntly
in p
lace
per
CM
S
• C
onse
nt re
quire
d by
eac
h co
nsum
er (A
OR
form
) bef
ore
you
can
proc
eed
to
1) c
ondu
ct a
n on
line
pers
on s
earc
h 2)
ass
ist w
ith c
ompl
etin
g a
Mar
ketp
lace
app
licat
ion
3) a
ssis
t with
pla
n se
lect
ion
and
enro
llmen
t 4)
ass
ist w
ith o
ngoi
ng a
ccou
nt/e
nrol
lmen
t mai
nten
ance
usi
ng
the
Dire
ct E
nrol
lmen
t Pat
hway
.
For m
ore
info
rmat
ion
on th
e co
nsum
er c
onse
nt re
quire
men
t, se
e th
is
reso
urce
: http
s://w
ww.
cms.
gov/
CC
IIO/P
rogr
ams-
and-
Initi
ativ
es/H
ealth
-In
sura
nce-
Mar
ketp
lace
s/D
ownl
oads
/AB
-Sum
mit-
Mas
terin
g-A
gent
-Bro
ker-
Com
plia
nce.
8
Sof
theo
n B
illin
g an
d E
nrol
lmen
t S
yste
m
9
Sof
theo
n B
illin
g an
d En
rollm
ent S
yste
m
• S
ofth
eon
is a
clo
ud-b
ased
ser
vice
that
is re
spon
sibl
e fo
r ha
ndlin
g C
omm
unity
’s e
nrol
lmen
ts a
nd in
voic
ing
need
s,
incl
udin
g th
e br
oker
enr
ollm
ent p
orta
l
• C
omm
unity
onl
y re
ceiv
es th
e ef
fect
uate
d fil
es (m
embe
rs
who
hav
e pa
id th
eir f
irst p
rem
ium
) w
ho a
re th
en lo
aded
in
to th
e el
igib
ility
and
cla
ims
paym
ent s
yste
ms
• M
embe
rs w
ill n
ot re
ceiv
e m
ater
ials
incl
udin
g M
embe
r W
elco
me
Pac
kets
, or I
D c
ards
unt
il th
e m
embe
r ha
s ef
fect
uate
d co
vera
ge a
nd s
elec
ted
a P
rimar
y C
are
Phy
sici
an
• If
a P
CP
is n
ot s
elec
ted,
one
will
be
assi
gned
10
Pay
men
ts
• O
nce
a m
embe
r enr
olls
in a
Com
mun
ity p
lan
they
will
be
able
to m
ake
thei
r ini
tial
paym
ent a
nd a
ny o
ngoi
ng p
aym
ents
: –
Onl
ine
via
our w
ebsi
te
– Pa
y-by
-pho
ne b
y ca
lling
Com
mun
ity d
irect
ly
• op
tion
to s
peak
to a
repr
esen
tativ
e •
optio
n to
pay
by
IVR
pay
men
t pro
mpt
s w
ithou
t spe
akin
g to
an
indi
vidu
al
– M
aile
d m
oney
ord
er o
r che
ck to
add
ress
on
billi
ng s
tate
men
t (m
ust
incl
ude
subs
crib
er ID
or
mon
ies
cann
ot b
e ap
plie
d)
• Fo
rms
of P
aym
ent A
ccep
ted:
–
Che
ck
– C
redi
t car
d (V
isa/
Mas
terc
ard/
Dis
cove
r)
– D
ebit
card
–
Mon
ey O
rder
• A
fter
mem
bers
hav
e m
ade
thei
r ini
tial b
inde
r pay
men
t, th
ey c
an s
et u
p re
curr
ing
paym
ents
onl
ine.
Pay
men
ts w
ill b
e de
duct
ed th
e 15
th o
r the
25th
of e
ach
mon
th fr
om
the
esta
blis
hed
acco
unt.
This
can
als
o be
com
plet
ed a
fter m
akin
g th
e in
itial
pay
men
t at
the
time
of e
nrol
lmen
t.
• M
embe
rs w
ho a
re s
et u
p on
recu
rrin
g pa
ymen
ts fo
r 201
9 th
at re
new
for 2
020
will
onl
y be
re
quir
ed to
re-e
stab
lish
recu
rring
pay
men
ts if
they
sel
ecte
d th
e “o
ther
am
ount
” pay
men
t op
tion
whe
n cr
eatin
g th
eir a
ccou
nt
11
• BIi
ngH
nma
f "
pp
ea,
Of1
')IO
I.JI'
(OTIH
h c;
ard)
Ml
Con
p,m
v N
rn
e
Ba
rlg
Add
r.s:
s
Str
I A
ddr
·2
TX. E
l 77
41l4
c::>-
ll
.,,, P
lea
se s
en
d m
e a
p.t
)'m
en
l con
finn.
"Jho
n e
ma
il
c,_
Cllr
d -r
ypo
Cra
lll
Car
d H
i.an
ber
E>
pn
llo
n
Cre
di! C
ard
Num
ber
Mon
lh,
--'IN
m
CV
Co
rCV
V
t:'.:I
Yo,
cv
v
< S
et T
h,,-
Aoc
mm
l Fo
r A
utop
a;:)
My
Acc
ount
D
f e;.1
ch m
on
lh
2~1h
Y
ou
r hr
.;;t p
iY
ffl n
t w
ill b
e m
Setti
ng u
p re
curri
ng p
aym
ents
• If
you
are
setti
ng u
p re
curr
ing
paym
ents
for t
he fi
rst t
ime
and
also
nee
d to
mak
e a
paym
ent:
You
can
acco
mpl
ish
this
by
mak
ing
your
initi
al
paym
ent (
popu
latin
g th
e pa
ymen
t inf
orm
atio
n) th
en s
elec
ting
“Set
Thi
s Ac
coun
t for
Aut
opay
”. By
doi
ng s
o yo
u w
ill se
e th
e sc
reen
on
the
right
ha
nd s
ide
that
will
allo
w th
e au
topa
y in
form
atio
n to
be
popu
late
d an
d pa
ymen
t sel
ectio
n da
te. T
his
will
als
o in
clud
e th
e fir
st d
ate
of a
utop
ay.
You
will
als
o ha
ve th
e op
tion
to re
ceiv
e an
em
ail c
onfir
mat
ion.
12
HEAL
TH C
HO
ICE
Wha
t wou
ld y
ou li
ke to
do
? Ret
urn
Hom
e
Con
tact
Info
rmat
ion
Mak
e a
Qui
ck P
aym
ent
lndi
v
Aut
omat
ic P
aym
ents
W
hy G
ive U
s Yo
ur E
mai
l Add
ress
? By
pro
vidi
ng y
our e
mai
l add
ress
, you
giv
e C
omm
unity
1
time.
The
se e
mai
ls w
ill be
sen
t to:
(1) h
elp
you
gel t
he m
ost o
ut o
f you
r hea
lth p
lan,
(2) k
e,
info
rmat
ion,
(3) h
elp
you
stay
as
heal
thy
as p
ossi
ble,
and
, (4)
occ
asio
nally
, req
uest
you
r le
•Ent
er y
our a
ccou
nt in
form
atio
n be
low
exa
ctly
as
it ap
pear
s on
you
r sta
tem
ent R
efer
to y
our m
ost r
ecen
t sla
fem
enl a
nd th
£
Cho
ose
a pa
ymen
t met
hod
• C
redi
t Car
d Pa
ymen
t C
heck
Pay
men
t <
:G,n
age
Recu
rring
Pay
me~
Ac
coun
t Nic
knam
e Pa
perle
ss P
refe
renc
es
Cha
nge
My
Addr
ess
Cha
nge
Alte
rnat
e Ad
dres
s
View
Dep
ende
nts
Add
a D
epen
dent
Rem
ove
a D
epen
dent
Cha
nge
My
Prov
ider
View
My
Bene
fits
Acco
unt
His
tory
Invo
ice
Hist
ory
Serv
ice R
eque
st H
isto
ry
End
My
Cov
erag
e
Cha
nge
Effe
ctiv
e D
ate
Polic
y H
isto
ry
Gen
erat
e In
voic
e
Sign
Out
My
Acc
ount
Billin
g Na
me
(as
it ap
pear
s on
you
r cre
dit c
ard)
Firs
t Nam
e
Billin
g Ad
dres
s
Stre
et A
ddre
ss 1
Stre
et A
ddre
ss 2
City
E-M
ail
Cred
it Ca
rd T
ype
Cred
it Ca
rd N
umbe
r
Cre
dit C
ard
Num
ber
El Zi
p
Ml
Expi
ratio
n
Mon
th
e a
date
for p
aym
ents
to b
e m
ade La
st N
ame
CV
Cor
CW
El Y
earE
] cw
e
each
mon
th
Your
firs
t pay
men
t will
be m
ade
on 1
1115
1201
7 ¢
the
amou
nt to
pay
Mem
ber r
ecur
ring
paym
ent o
ptio
ns
• M
embe
rs c
an s
et u
p or
man
age
recu
rrin
g pa
ymen
ts o
nlin
e •
Aut
omat
ic P
aym
ents
ca
n be
mad
e by
ch
ecki
ng/s
avin
gs
acco
unt o
r cre
dit
card
•
Pay
men
t opt
ions
in
clud
e th
e 15
th o
r 25
th o
f the
mon
th
(ple
ase
note
pay
men
ts a
re
due
prio
r to
the
cove
rage
m
onth
)
13
HEAL
TH C
HOIC
E
End
My
Cove
rage
Chan
ge E
ffecti
ve D
ate
Polic
y Hi
story
Gen
erat
e In
voice
Sign
Out
Indi
vidu
al &
Fam
ily
Cred
tt Ca
rd N
umbe
r Ex
pirat
ion
CV
Cor
CW
Cred
it Ca
rd N
umbe
r M
onth
El
Yea
rE]
cw e
Ch
oose
a da
te fo
r pay
men
ts to
be m
ade
15th
E]
of e
ach
mon
th
Your
first
paym
ent w
ill be
mad
e on
11/
15/2
017
Choo
se th
e am
ount
to p
ay
• To
tal A
mou
nt D
ue
0.00
Mon
thly
Prem
ium
120.
39
Oth
er A
mou
nt
O 00
I Requ
ired
field
s ar
e de
note
d by
a co
lore
d ba
r.
0 0
Plea
se n
ote th
at by
sele
cting
''Tota
l Am
ount
Due"
, this
amou
nt is
subje
ct to
chan
ge b
ased
on
your
late
st ou
tstan
ding
balan
ce o
n the
recu
rring
pa
ymen
t dat
e.
Back
Brok
ers -
Rec
urrin
g Pa
ymen
t Opt
ions
Opt
ion
1: T
otal
Am
ount
Due
By
sele
ctin
g to
tal a
mou
nt d
ue th
e m
embe
r is
agre
eing
to p
ay th
e fu
ll am
ount
ow
ed, i
nclu
ding
any
out
stan
ding
pay
men
ts
14
HE
ALT
H C
HO
ICE
End
My
Cov
erag
e
Cha
nge
Effe
ctiv
e D
ate
Pol
icy
His
tory
Gen
erat
e In
voic
e
Sig
n O
ut
Indi
vidu
al &
Fam
ily
Cre
dit C
ard
Num
ber
Expi
ratio
n C
VC
orC
W
Cre
dit
Car
d N
umbe
r M
onth
El
Y
ea
rE]
cw
e C
hoos
e a
date
for p
aym
ents
to b
e m
ade
15th
E]
of e
ach
mon
th
You
r firs
t pay
men
t will
be
mad
e on
11/
15/2
017
Cho
ose
the
amou
nt to
pay
• To
tal A
mou
nt D
ue
000
Mon
thly
Pre
miu
m
120.
39
Oth
er A
mou
nt
0 00
I Req
uire
d fie
lds
are
deno
ted
by a
col
ored
bar
.
0 0
Plea
se n
ote
that
by
sele
ctin
g "M
onth
ly
Prem
ium
", th
is a
mou
nt is
sub
ject
to
chan
ge b
ased
on
your
mon
thly
pr
emiu
m a
ssoc
iate
d w
ith y
our l
ates
t po
licy
on th
e re
curri
ng p
aym
ent d
ate.
Bac
k
Bro
kers
-
Rec
urrin
g Pa
ymen
t Opt
ions
• O
ptio
n 2:
Mon
thly
Pre
miu
m
• B
y se
lect
ing
mon
thly
pre
miu
m th
e m
embe
r is
agre
eing
to p
ay
only
the
mon
thly
pre
miu
m a
mou
nt (n
ot a
ny o
utst
andi
ng
paym
ents
ow
ed)
15
HE.A
CTH
CH
OIC
B
End
My
Cov
erag
e
Cha
nge
Effe
ctiv
e D
ate
Polic
y H
isto
ry
Gen
erat
e In
voic
e
Sign
Out
Cre
dit C
ard
Num
ber
Expi
ratio
n C
VC
orC
W
Cre
dit C
ard
Num
ber
Mon
th
El
Yea
rE]
cw e
Ch
oose
a d
ate
for p
aym
ents
to b
e m
ade
15th
E]
of e
ach
mon
th
Your
firs
t pay
men
t will
be m
ade
on 1
1/15
/201
7
Choo
se th
e am
ount
to p
ay
• To
tal A
mou
nt D
ue
0.00
0
Mon
thly
Pre
miu
m
120.
39
0
Oth
er A
mou
nt
O 00
I Req
uire
d fie
lds
are
deno
ted
by a
col
ored
bar
.
Indi
vidu
al &
Fam
ily
Bro
kers
Back
-
Rec
urrin
g Pa
ymen
t Opt
ions
Opt
ion
3: O
ther
Am
ount
B
y se
lect
ing
othe
r am
ount
the
mem
ber i
s ag
reei
ng to
pay
onl
y th
e am
ount
en
tere
d (o
r an
amou
nt th
ey h
ave
deci
ded
at th
e tim
e au
to p
aym
ents
wer
e se
t up)
. Ple
ase
note
, if t
his
amou
nt is
less
than
wha
t is
due
they
will
go in
to
Gra
ce P
erio
d.
16
Bill
ing
Cyc
le a
nd G
race
Per
iod
• M
embe
rs p
rem
ium
s ar
e du
e by
the
first
day
of t
he c
over
age
mon
th
– e.
g. F
ebru
ary’
s pr
emiu
m is
due
no
late
r tha
n Fe
brua
ry 1
st
• P
aym
ents
not
rece
ived
by
the
first
day
of t
he c
over
age
mon
th a
re c
onsi
dere
d la
te
• Te
rmin
atio
ns a
re p
roce
ssed
on
the
5th
of e
ach
mon
th
• M
embe
rs w
ho h
ave
AP
TC re
ceiv
e a
90 d
ay g
race
per
iod
only
aft
er th
e bi
nder
pa
ymen
t has
bee
n m
ade
in fu
ll to
effe
ctua
te c
over
age
• M
embe
rs w
ho d
o no
t hav
e A
PTC
rece
ive
a 30
day
gra
ce p
erio
d on
ly a
fter
the
bind
er p
aym
ent h
as b
een
mad
e in
full
to e
ffect
uate
cov
erag
e
• M
embe
rs w
ho e
nter
gra
ce w
ill o
nly
com
e ou
t of g
race
per
iod
if al
l cur
rent
and
pa
st d
ue p
rem
ium
s ar
e pa
id b
efor
e th
e en
d of
the
grac
e pe
riod
cycl
e
• In
201
8, C
MS
pas
sed
new
regu
latio
ns re
late
d to
mem
bers
who
term
inat
e fo
r no
n-pa
ymen
t tha
t pre
vent
s m
embe
rs fr
om re
-enr
ollin
g w
ithou
t pay
ing
back
pas
t du
e pr
emiu
ms.
Thi
s w
ill c
ontin
ue to
be
enfo
rced
by
Com
mun
ity H
ealth
Cho
ice
in
2020
17
Bill
ing
and
Enro
llmen
t Ter
min
olog
y
• P
assi
ve E
nrol
lmen
t – A
n en
rollm
ent w
here
the
mem
ber r
emai
ns w
ith th
e sa
me
Qua
lifie
d H
ealth
P
lan
unde
r the
sam
e pl
an
• G
race
Per
iod
– A
tim
efra
me
give
n to
mem
bers
to a
llow
the
mem
ber t
o pa
y al
l pas
t due
am
ount
s to
avo
id b
eing
term
inat
ed fo
r non
pay
men
t. N
ote:
Gra
ce p
erio
d on
ly a
pplie
s to
effe
ctua
ted
polic
ies
• B
inde
r P
aym
ent
– Th
e in
itial
pay
men
t req
uire
d to
effe
ctua
te c
over
age
for t
he fi
rst m
onth
of t
he
polic
y
• E
ffec
tuat
e –
A p
olic
y is
con
side
red
effe
ctua
ted
whe
n th
e bi
nder
pay
men
t is
mad
e in
full
to a
ctiv
ate
polic
y
• P
olic
y R
ate
Am
ount
– T
he s
tand
ard
rate
for a
ll m
embe
rs. T
he p
olic
y ra
te a
mou
nt is
bas
ed o
n ag
e, to
bacc
o us
er, p
lan
sele
cted
and
ratin
g ar
ea
• A
PTC
(A
dvan
ced
Pre
miu
m T
ax C
redi
t) –
Fin
anci
al a
ssis
tanc
e (s
ubsi
dies
) pro
vide
d by
the
Fede
ral G
over
nmen
t giv
en to
indi
vidu
als
who
app
ly fo
r cov
erag
e th
roug
h H
C.g
ov a
nd m
eet
all q
ualif
icat
ions
. The
am
ount
var
ies
from
fam
ily to
fam
ily
�Fa
mili
es a
pply
ing
for A
PTC
sho
uld
list h
ead
of h
ouse
hold
as
the
subs
crib
er
�In
divi
dual
s re
ceiv
ing
AP
TC m
ust f
ile in
com
e ta
x re
turn
�
Indi
vidu
als
who
pro
vide
inac
cura
te o
r inc
ompl
ete
info
rmat
ion
are
subj
ect t
o pe
nalti
es a
nd
may
ow
e ba
ck a
ll su
bsid
y re
ceiv
ed
18
Bill
ing
and
Enro
llmen
t Ter
min
olog
y C
ontin
ued
• C
SR
(Cos
t Sha
re R
educ
tion)
– A
redu
ctio
n of
cos
t for
hea
lth b
enef
its fo
r in
divi
dual
s w
ho a
re e
nrol
led
in a
qua
lifie
d S
ilver
pla
n. H
ealth
ben
efits
in
clud
e de
duct
ible
s, c
oins
uran
ce, c
opay
s, o
r oth
er s
imila
r cha
rges
(doe
s no
t ap
ply
to p
rem
ium
). M
embe
rs q
ualif
y fo
r CS
R b
ased
on
inco
me
repo
rted.
• P
ast D
ue A
mou
nt –
The
am
ount
the
mem
ber o
wes
for m
onth
s th
at w
ere
not p
aid
by th
e du
e da
te.
• P
aid
Thro
ugh
Dat
e –
The
date
in w
hich
the
mem
ber h
as m
ade
timel
y pa
ymen
ts. N
ote:
The
Pai
d th
roug
h da
te d
oes
not r
oll o
ver i
f a p
artia
l pa
ymen
t is
mad
e.
• C
laim
s P
aid
Thro
ugh
Dat
e –
The
date
cal
cula
ted
for A
PTC
mem
bers
, the
ca
lcul
ated
dat
e is
the
Pai
d th
roug
h da
te +
1 m
onth
. The
Cla
ims
Pai
d Th
roug
h D
ate
will
not b
e gr
eate
r tha
n th
e te
rmin
atio
n da
te.
• Fi
nanc
e P
aid
Thro
ugh
Dat
e –
The
date
cal
cula
ted
for m
embe
rs s
olel
y ba
sed
on p
rem
ium
s an
d pa
ymen
ts. T
he F
inan
ce P
aid
Thro
ugh
Dat
e do
es
not l
ook
at w
heth
er th
e pa
ymen
t was
mad
e on
tim
e.
19
HEAL
TH IN
SURA
NCE
MARK
ETPL
ACE
QUICK
, MAK
E YOU
R LIFE
EASIE
R.
Creat
e an o
nline
accou
nt so
you ca
n:
Q• Pri
nt a t
empo
rary I
D card
• Find
a do
ctor o
r phar
macy
• Chec
k you
r Mem
ber ha
ndbo
ok
Q • Se
nd se
cure
messa
ges
• Make
a qu
ick pa
ymen
t
• Mana
ge au
tomati
c paym
ents
• Sign
up fo
r pap
erless
billin
g
• Upd
ate yo
ur ad
dress
• View
your
depe
nden
ts
Q• Ch
ange a
Prov
ider
• View
your
bene
fits
[QUIC
K PAY
MENT
] Ma
ke a p
ayme
nt wi
thout
creati
ng an
acco
unt o
r log
ging i
nto yo
ur acc
ount.
NOTE
: Com
munit
y Heal
th Ch
oice i
s not
affilia
ted w
ith Co
mmun
ityOu
ickCa
re. Pl
ease m
ake A
ll Com
munit
y He
alth C
hoice
Mark
etplac
e paym
ents b
y sign
ing in
to
your o
nline
accou
nt or
using
our O
ulck P
ay op
tion.
MEMB
ER LO
G IN
Usern
ame
Passw
ord
Reme
mber
Me
-
Mem
ber P
orta
l Acc
ess •
Mem
bers
who
crea
te a
n on
line
acco
unt a
re a
ble
to u
se se
lf-se
rve
func
tiona
lity
inclu
ding
: •
Send
secu
re e
mai
l to
Mem
ber
Serv
ices
• Pr
int t
empo
rary
ID ca
rds
• Su
bmit
a re
ques
t to
add
or
chan
ge a
Prim
ary
Care
Phy
sicia
n (P
CP)
• M
ake
one-
time
paym
ents
“Q
uick
Pay
men
t”
• Se
t-up
or m
anag
e re
curr
ing
paym
ents
•
Part
icipa
te in
the
2020
Wel
lnes
s Pr
ogra
m a
nd e
arn
gift
card
s
20
· H
EALT
H C
HO
ICE
Wha
t wou
ld y
ou li
ke to
do
? Ret
urn
Hom
e
Con
tact
Info
rmat
ion
Mak
e a
Qui
ck P
aym
ent
Man
age
Rec
urrin
g Pa
ymen
ts
Pape
rless
Pre
fere
nces
Cha
nge
My
Addr
ess
Cha
nge
Alte
rnat
e Ad
dres
s
View
Dep
ende
nts
Add
a D
epen
d ent
Rem
ove
a D
epen
dent
Cha
nge
My
Prov
ider
View
My
Bene
fits
Acc
ount
His
tory
Invo
ice
Hist
ory
Hom
e Sh
owin
g de
tails
for 1
/1/2
017
-12/
31/2
017
Paym
ent S
tatu
s
Unp
aid
Mon
thly
Pre
miu
m
$180
.04
$426
.56
Prem
ium
-$2
46.5
2 A
PTC
Last
Pay
men
t
$180
.04
on 8
/27/
2017
11
1\.
IIY
IUU
GI
a ra
11
11
1y
li
iiil
llV
l\.'
CI~
Nex
t Pay
men
t Due
$360
.08
Due
In
13 D
ays
by 1
0/31
/201
7
Paid
Thr
ough
Dat
e
9/30
/201
7 A
grac
e pe
riod
is wh
en y
ou a
re s
till
cove
red,
but
hav
e a
late
pay
men
t You
m
ust e
xn th
e gr
ace
perio
d in
a ce
rtain
am
ount
of t
ime
to a
void
losin
g yo
ur
heal
th c
over
age.
Mem
ber P
orta
l Acc
ess
• G
race
Per
iod
info
rmat
ion
can
be v
iew
ed o
n th
e M
embe
r Por
tal
21
Rec
ap
• A
PTC
Mem
bers
rece
ive
a 90
day
gra
ce p
erio
d
• N
on-A
PTC
Mem
bers
rece
ive
a 30
day
gra
ce p
erio
d
• G
race
Per
iod
does
NO
T ro
ll ov
er, t
he m
embe
r mus
t pay
all
past
du
e pr
emiu
m a
mou
nts
to e
xit t
he G
race
Per
iod
befo
re th
e en
d of
th
e G
race
Per
iod
cycl
e
• B
egin
ning
in 2
018,
CM
S p
asse
d a
new
regu
latio
n al
low
ing
Hea
lth
Pla
ns to
cha
rge
all p
ast d
ue p
rem
ium
s ca
rrie
d ov
er in
ord
er to
ef
fect
uate
cov
erag
e. C
omm
unity
will
con
tinue
to e
nfor
ce th
is
regu
latio
n in
202
0 an
d co
llect
pas
t due
am
ount
s.
22
Plan
s, B
enef
its &
Rat
es
23
Adv
ance
d Pr
emiu
m T
ax C
redi
ts (A
PTC
)
• Ta
x cr
edit
subs
idie
s av
aila
ble
thro
ugh
the
exch
ange
are
ca
lled
Adv
ance
d P
rem
ium
Tax
Cre
dits
(AP
TC)
• AP
TC’s
ass
ist m
embe
rs w
ith th
eir m
onth
ly p
rem
ium
• W
ho is
elig
ible
for A
PTC
? 9
Indi
vidu
al e
arns
bet
wee
n 10
0%-4
00%
Fed
eral
Pov
erty
Lev
el (F
PL)
9
Indi
vidu
al is
not
elig
ible
for c
over
age
thro
ugh
thei
r em
ploy
er,
Med
icai
d, o
r Med
icar
e*
�O
r em
ploy
er s
pons
ored
cov
erag
e is
mor
e th
an 9
.5%
of t
heir
inco
me
�O
r em
ploy
er s
pons
ored
cov
erag
e do
esn’
t mee
t min
imum
ess
entia
l co
vera
ge re
quire
men
ts
�Th
e on
ly w
ay to
get
APT
C is
to e
nrol
l “O
n Ex
chan
ge”
24
Cos
t Sha
ring
Red
uctio
n Pl
ans
• C
SR’s
will
still
exis
t in
2020
• E
nrol
lees
<25
0% F
eder
al P
over
ty L
evel
(FP
L) a
re e
ligib
le
for C
ost S
harin
g R
educ
tion
(CS
R) p
lans
• O
nly
Silv
er le
vel p
lans
hav
e C
SR b
enef
its
• C
ost S
harin
g R
educ
tions
mea
n re
duce
d co
pays
, co
insu
ranc
es, a
nd lo
wer
out
-of-p
ocke
t max
imum
s
• Th
ere
are
3 S
ilver
CS
R p
lans
: •
Silv
er 7
3 =
201-
250%
FP
L •
Silv
er 8
7 =
151-
200%
FP
L •
Silv
er 9
4 =
100-
150%
FP
L •
If a
pote
ntia
l enr
olle
e ea
rns
<100
% F
PL,
they
are
not
elig
ible
for C
SR
pl
ans
unle
ss th
ey m
eet s
peci
fic c
riter
ia
25
Lim
ited
and
Zero
Cos
t Sha
ring
Plan
s
If a
cons
umer
is a
mem
ber o
f the
fede
rally
reco
gnize
d tr
ibe
or a
n Al
aska
Nat
ive
Clai
ms S
ettle
men
t Act
Cor
pora
tion
shar
ehol
der,
they
may
qua
lify
for a
dditi
onal
co
st-s
harin
g re
duct
ions
.
To le
arn
mor
e: h
ttps:
//ww
w.he
alth
care
.gov
/am
eric
an-in
dian
s-al
aska
-nat
ives
/
Zero
Cos
t Sha
ring
Pla
ns
Lim
ited
Cos
t Sha
ring
Pla
ns
• P
ay $
0 co
pays
or 0
%•
Nat
ive
Am
eric
ans,
100-
300%
co
insu
ranc
e at
Indi
an H
ealth
FP
L an
d qu
alify
for A
PTC
S
ervi
ce P
rovi
ders
* on
ly
• P
ay $
0 co
pays
or 0
%
– G
old
Lim
ited
Cos
t Sha
ring
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has
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ed.
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con
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to p
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ons
for S
EP e
nrol
lmen
ts
28
2020
Mar
ketp
lace
Pla
n Up
date
s
• To
tal o
f 6 p
lans
for 2
020
that
are
rene
win
g w
ith m
inim
al c
hang
es
• Tw
o pl
ans
bein
g di
scon
tinue
d »
Com
mun
ity S
ilver
HM
O 0
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pla
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» C
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Hea
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s (0
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nd
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• M
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nrol
led
in d
isco
ntin
ued
plan
s ar
e be
ing
cros
s w
alke
d to
oth
er
Com
mun
ity p
lans
• 20
20 P
lans
: –
Com
mun
ity H
ealth
Cho
ice
HM
O G
old
001
– C
omm
unity
Hea
lth C
hoic
e H
MO
Bro
nze
003
– C
omm
unity
Hea
lth C
hoic
e H
MO
Silv
er 0
04
– C
omm
unity
Hea
lth C
hoic
e H
MO
Gol
d 00
5 –
Com
mun
ity H
ealth
Cho
ice
HM
O H
igh
Ded
uctib
le H
ealth
Pla
n H
SA C
ompa
tible
008
–
Com
mun
ity H
ealth
Cho
ice
HM
O S
ilver
009
29
He
alth
y Li
fe
for E
very
Tex
an
Com
mun
ityH
ealth
Cho
ice.
org
COM
MUN
ITY
~ H
EALT
H C
HO
ICE
2020
Sal
es G
uide
30
20
19
2020
COST
SHA
RE
HM
O B
ronz
e D
educ
tible
003
HM
O B
ronz
e Pl
an ID
272
48T
X00
1000
3 M
edic
al D
educ
tible
(ind
ivid
ual/f
amily
) $5
,soo
I $n
,ooo
$7
,150
/ $14
,300
O
ut-o
f-Po
cket
Max
(ind
ivid
ual/f
amily
) $1
,900
I $1
5,so
o $8
,150
/ $1
6,30
0 M
EDIC
AL
BENE
FITS
PC
P O
ffice
Vis
it
*$40
*$
40
Spe,c
ialis
t Offi
ce V
isit
*$70
*$
70
Out
patie
nt F
acili
ty
30%
30
%
Out
patie
nt S
urge
ry
30%
30
%
Urg
ent C
are
Serv
ices
*$
70
*$70
Am
bula
nce
Serv
ices
$7
0 $7
0 Em
erge
ncy
Room
Ser
vice
s 30
%
30%
In
patie
nt H
ospi
tal C
are
30%
30
%
Inpa
tient
Ski
lled
Nur
sing
Fac
ility
30
%
30%
O
utpa
tient
Men
tal/B
ehav
iora
l/Sub
stan
ce A
buse
*$
40
*$40
In
patie
nt M
enta
l/Be
havi
oral
/Sub
stan
ce A
buse
30
%
30%
O
utpa
tient
Reh
abili
tatio
n $7
0 $7
0 M
edic
al Im
agin
g 30
%
30%
(C
T/PE
T Sc
ans/
MR
l's)
Rou
tine
Lab/
X-R
ay/D
iagn
ostic
Imag
ing
$40
$40
PRES
CRIP
TIO
N D
RU
GS
*Pre
scrip
tion
Dru
g D
educ
tible
(ind
ivid
ual/f
amily
) Co
mbi
ned
with
Co
mbi
ned
with
90
day
mai
l ord
er s
uppl
y av
aila
ble
at 2
.5 x
cop
ay)
Med
ical
Ded
uctib
le
Med
ical D
educ
tible
G
ener
ic
*$15
*$
15
Pref
erre
d $7
0 $7
0 N
on~P
refe
rred
Bra
nd
$120
$1
2:0
Spec
ialty
Hig
h Co
st D
rugs
45
%
45%
* Ser
vice
s are
exe
mpt
from
ded
uctib
le w
here
indi
cate
d (P
CP/S
pecia
list/
Urg
ent C
are/
Gen
eric
RX/
Men
tal-B
ehav
iora
l Hea
lth O
ffice
Vis
its)
For D
educ
tible
Pla
ns: A
ll co
insu
ranc
e/co
pays
app
ly a
fte,r a
nnua
l ded
uctib
le h
as b
een
met
. Unl
ess
othe
rwis
e in
dica
ted
2020
Cha
nges
–
Bro
nze
Ded
uctib
le P
lan
003
31
20
20
2019
20
20
2019
20
20
2019
20
20
Com
mun
ity H
ealth
Cho
ice H
MO Si
lver D
educ
tible
Plans
004
MEM
BER
Silve
r Ded
uctib
le Si
lver D
educ
tible
Si
lver D
educ
tible
Silve
r Ded
uctib
le
Silve
r Ded
uctib
le
Silve
r Ded
uctib
le Si
lver D
educ
tible
CO
ST SH
ARE
004(
73)
004
(87)
Si
lver D
educ
tible
00
4 25
0% FP
L and
00
4 250
% FP
L and
00
4(73
)200
%-24
9%
004
(87)
150
%-1
99%
00
4(94
) 20
0%-2
49%
FPL
150%
-199
% FP
L and
004
(94)
100
%-1
49%
ab
ove
abov
e FP
L and
abo
ve
FPL a
nd a
bove
10
0%-1
49%
FPL
and a
bove
ab
ove
Med
ical D
educ
tible
(indiv
idual/
fam
ily)
$3,oo
o / $
6,000
$3
,ooo /
$6,0
00
$2,so
o / $
5,oo
o $2
,soo I $
5,60
0 N/
A N/
A N/
A N/
A Ou
t-of-P
ocke
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(ind
ividu
al/fa
mily
) $7
,900
/ 15
,soo
$7,9
00 I 1
5,so
o $6
,300
/ $1
2,60
0 $6
,soo
/ $13
,ooo
$2
,600 /
$5,2
00
$2, 7
00 /
$5,4
00
$2,so
o / $
5,oo
o $2
,500
/ $5
,000
ME
DICA
L BEN
EFITS
PC
P Offic
e Vi
sit
*$30
*$
30
*$25
*$
25
$20
$25
$10
$10
Spec
ialis
t Offic
e Visi
t *$
60
*$60
'$S
O '$S
O $SO
$SO
$2
0 $2
0 O
utpa
tient
Facil
ity
30%
30
%
30%
30%
20
%
20%
10
%
10%
O
utpa
tient
Sur
gery
30%
30
%
30%
30%
20
%
20%
10
%
10%
Ur
gent
care
Servi
ces
*$60
*$
60
'$SO
'$SO
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$20
$20
Ambu
lance
Ser
vices
$6
0 $6
0 $SO
$SO
$SO
$SO
$2
0 $2
0 Em
erge
ncy R
oom
Servi
ces
30%
30
%
30%
30%
20
%
20%
10
%
10%
In
patie
nt H
ospit
al ca
re
30%
30
%
30%
30%
20
%
20%
10
%
10%
In
patie
nt S
killed
Nur
sing F
acilit
y 30
%
30%
30
% 30
%
20%
20
% 10
%
10%
O
utpa
tient
Men
tal/B
ehav
ioral/
Subs
tanc
e Ab
use
*$30
*$
30
*$25
*$
25
$20
$25
$10
$10
Inpa
tient
Men
tal/B
ehav
iora
l/Sub
stanc
e Abu
se
30%
30
%
30%
30%
20
%
20%
10%
10
%
Out
patie
nt R
ehab
ilita
tion
$60
$60
$SO
$SO
$SO
$SO
$10
$10
Med
ical Im
aging
(C
T/PET
Scan
s/MRl
's)
30%
30
%
30%
30%
20
%
20%
10%
10
%
Routi
ne L
ab/X
-Ray
/Diag
nosti
c Ima
ging
$3
0 $3
0 $2
5 $2
5 $2
0 $2
5 $1
0 $1
0 PR
ESCR
IPTIO
N DR
UGS
'Pre
scrip
tion
Drug
Ded
uctib
le (in
divid
ual/fa
mily
) Co
mbin
ed w
ith
Comb
ined
with
Co
mbin
ed w
ith
Com
bine
d with
90
day m
ail o
rder
supp
ly av
ailab
le at
2.5 x
copa
y) M
edica
l Ded
uctib
le M
edica
l Ded
uctib
le M
edica
l Ded
uctib
le M
edica
l Ded
uctib
le
N/A
N/A
N/A
N/A
Gene
ric
'$10
*$
10
*$10
'$
10
$10
$10
$5
$5
Prefe
rred
$60
$60
$SO
$S
O
$45
$SO
$20
$20
Non-
Prefe
rred
Bran
d $1
00
$100
$9
0 $9
0 $8
5 $85
$4
0 $4
0 Sp
ecial
ty H
igh C
ost D
rugs
45%
45
%
40%
40
%
30%
30
% 20
% 20
%
• Ser
vices
are
exem
pt fr
om d
educ
tible
wher
e in
dicate
d (P
CP/S
pecia
list/U
rgent
Care
/Gen
eric
RX/M
enta
l-Beh
avior
al He
alth
Offic
e Vi
sits)
t Fo
r Ded
uctib
le Pla
ns: A
ll coi
nsura
nce/c
opay
s app
ly af
ter a
nnua
l ded
uctib
le ha
s bee
n m
et. U
nless
oth
erwi
se in
dicat
ed
2020
Cha
nges
–
Silv
er D
educ
tible
Pla
ns 0
04
32
20
19
2020
M
EMBE
R
COST
SHA
RE
Gol
d D
educ
tible
005
Pla
n ID
2n4
8TX
1000
5 G
old
Ded
uctib
le 0
05 P
lan
ID 2
7248
TX10
005
Med
ical
Ded
uctib
le (i
ndiv
idua
l/fa
mily
) $7
50 /
$1,5
00
$750
/ $1
,500
O
ut-o
f-P
ocke
t Max
(ind
ivid
ual/f
amily
) $6
,000
/ $1
2,00
0 $6
,500
/ $1
3,00
0 M
EDI C
AL B
ENEF
ITS
PCP
Off
ice
Vis
it
*$20
*$
20
Spec
ialis
t Offi
ce V
isit
*$40
*$
40
Out
patie
nt F
acili
ty
20%
20
"/4
Out
patie
nt S
urge
ry
2'0%
2'0
%
Urg
ent c
are
Serv
ices
*$
40
*$40
A
mbu
lanc
e Se
rvic
es
$40
$40
Emer
genc
y R
oom
Ser
vice
s 20
%
20%
In
patie
nt H
ospi
tal c
are
2'0%
2'0
%
Inpa
tient
Ski
lled
Nur
sing
Fac
ility
20
%
2'0%
O
utpa
tient
Men
tal/B
ehav
iora
l/Sub
stan
ce A
buse
*$
20
*$20
In
patie
nt M
enta
l/Beh
avio
ral/S
ubst
ance
Abu
se
20%
20
%
Out
patie
nt R
ehab
ilita
tion
$40
$40
Med
ical
Imag
ing
(CT/
PIT
Sca
ns/M
Rl's
) 20
%
20%
R
outin
e La
b/X-
Ray
/Dia
gnos
tic Im
agin
g $2
0 $2
0 PR
ESCR
IPTI
ON
DRUG
S
* Pre
scrip
tion
Dru
g D
educ
tible
(in
divi
dual
/fam
ily)
Com
bine
d w
ith
Com
bine
d w
ith
90 d
ay m
ail o
rder
sup
ply
avai
labl
e at
2.5
x co
pay)
M
edic
al D
educ
tible
M
edic
al D
educ
tible
G
ener
ic
*$l0
*$
l0
Pref
erre
d $4
0 $4
0 N
on-P
refe
rred
Bra
nd
$70
$70
Spe;c
ialty
Hig
h C
ost D
rugs
30
%
30%
* Se
rvic
es a
re e
xem
pt fr
om d
educ
tible
-whe
re in
dica
ted
(PCP
/Spe
cial
ist/U
rgen
t Car
e/G
ener
ic R
X/M
enta
l-Beh
avio
ral H
ealth
Offi
ce V
isits
) Fo
r Ded
uctib
le P
lans
: All
coin
sura
nce/
copa
ys a
pply
aft
e,r a
nnua
l ded
uctib
le h
as b
e;en
met
. Unl
ess
othe
rwis
e in
dica
ted
2020
Cha
nges
–
Gol
d D
educ
tible
Pla
n 00
5
33
2019
20
20
COST
SHA
RE
Gol
d Co
pay 0
01 P
lan
ID 2
7248
TX
0010
001
Gol
d C
opay
001
Pla
n ID
272
48TX
0010
001
Med
ical
Ded
uctib
le (i
ndiv
idua
l/fam
ily)
N/A
N
/A
Out
-off-
Pock
et M
ax (i
ndiv
idua
l/fa
mily
) $7
,900
/ $1
5,80
0 $8
,150
I $16
,300
M
EDIC
AL B
ENEF
ITS
PCP
Offi
ce V
isit
$3
0 $3
0 Sp
ecia
list O
ffice
Vis
it $6
5 $6
5 O
utpa
tient
Faci
lity
$300
$3
00
Out
patie
nt S
urge
ry
$300
$3
00
Urg
ent C
are
Serv
ices
$6
5 $6
5 A
mbu
lanc
e Se
rvic
es
$65
$65
Emer
genc
y R
oom
Ser
vice
s $6
00
$700
In
patie
nt H
ospi
tal C
are
**$6
00
**$7
00
Inpa
tient
Ski
lled
Nur
sing
Fac
ility
**
$600
**
$700
O
utpa
tient
Men
tal/
Beha
vior
al/S
ubst
ance
Abu
se
$30
$30
Inpa
tient
Men
tal/B
ehav
iora
l/Su
bsta
nce
Abus
e **
$600
**
$700
O
utpa
tient
Reh
abili
tatio
n $6
5 $6
5 M
edic
al Im
agin
g (C
T/PE
T Sc
ans/
MR
l's)
$500
$7
00
Rou
tine
Lab/
X-R
ay/D
iagn
ostic
Imag
ing
$30
$30
PRES
CRIP
TIO
N DR
UGS
*Pre
scrip
tion
Dru
g D
educ
tible
(ind
ivid
ual/f
amily
) 90
day
mai
l ord
er su
pply
ava
ilabl
e at
2.5
x co
pay)
N
/A
N/A
G
ener
ic
$15
$20
Pref
erre
d $4
0 $4
0 N
on-P
refe
rred
Bra
nd
$80
$80
Spec
ialty
Hig
h Co
st D
rugs
30
%
30%
** C
opay
app
lies
for f
irst 5
day
s off a
dmis
sion
for a
ll in
patie
nt se
rvic
es
2020
Cha
nges
– G
old
Cop
ay P
lan
001
34
20
20
MEM
BER
Hi
gh D
educ
tible
Hea
lth P
lan
HSA
High
Ded
uctib
le H
ealth
Pla
n HS
A CO
ST S
HARE
C
ompa
tible
C
ompa
tible
Pl
an ID
2724
81X0
0100
08
Pian
ID 2
7248
1X00
1000
8 M
edic
al D
educ
tible
(ind
ivid
ual/f
amily
) $6
,750
/ $1
3,50
0 $6
,750
/ $1
3,50
0 O
ut-o
f-Po
cket
Max
(ind
ivid
ual/f
amily
) $6
,750
/ $1
3,50
0 $6
,750
/ $1
3,50
0 M
EDIC
AL B
ENEF
ITS
PCP
Off
ice
Visi
t N
o Ch
arge
aft
er d
educ
tible
N
o,Ch
arge
, afte
r ded
uctib
le
Spec
ia I i
st O
ffice
Vis
it
No
Char
ge a
fter d
educ
tible
N
o Ch
arge
.afte
r ded
uctib
le
Out
patie
nt F
acili
ty
No
Char
ge a
fter d
educ
tible
N
o Ch
arge
,afte
r ded
uctib
le
Out
patie
nt S
urge
ry
No
Char
ge a
fter
ded
uctib
le
No
Char
ge .a
fter d
educ
tible
U
rgen
t Car
,e Se
rvic
es
No
Char
ge a
fter
ded
uctib
le
No
Char
ge ,a
fter d
educ
tible
A
mbu
lanc
e Se
rvic
es
No
Char
ge a
fter
ded
uctib
le
No
Char
ge .a
fter
ded
uctib
le
Emer
genc
y Ro
om S
ervi
ces
No
Char
ge a
fter d
educ
tible
N
o Ch
arge
,afte
r ded
uctib
le
Inpa
tient
Hos
pita
l car
e N
o Ch
arge
aft
er d
educ
tible
N
o Ch
arge
.afte
r ded
uctib
le
Inpa
tient
Ski
lled
Nur
sing
Fac
ility
N
o Ch
arge
aft
er d
educ
tible
N
o Ch
arge
,aft
er d
educ
tible
O
utpa
tient
Men
tal/
Beh
avio
ral/S
ubst
ance
Abu
se
No
Char
ge a
fter
ded
uctib
le
No
Char
ge .a
fter
ded
uctib
le
Inpa
tient
Men
tal/
Beh
avio
ral/
Subs
tanc
e· A
buse
N
o Ch
arge
aft
er d
educ
tible
N
o Ch
arge
,afte
r ded
uctib
le
Out
patie
nt R
ehab
ilita
tion
No
Char
ge a
fter
ded
uctib
le
No
Char
ge .a
fter d
educ
tible
M
edic
al Im
agin
g (C
T/PE
T Sc
ans/
MR
l's)
No
Char
ge a
fter
ded
uctib
le
No
Char
ge .a
fter
ded
uctib
le
Rout
ine
Lab/
X-R
ay/D
iagn
ostic
Imag
ing
No
Char
ge a
fter
ded
uctib
le
No
Char
ge ,a
fter d
educ
tible
PR
ESCR
IPTI
ON
DRUG
S Pr
escr
iptio
n Dr
ug D
educ
tible
(ind
ivid
ual/f
amily
) Co
mbi
ned
with
Co
mbi
ned
with
00
day
mai
l ord
e,r s
uppl
y av
aila
ble
at 2
.5 x
copa
y)
Med
i,cal
Ded
uctib
le
Med
ical
Ded
uctib
le
Gen
eric
N
o Ch
arge
afte
r ded
uctib
le
No
Char
ge ,a
fter d
educ
tible
Pr
efer
red
No
Char
ge a
fter
ded
uctib
le
No
Char
ge a
fter d
educ
tible
N
on~P
refe
rred
Bra
nd
No
Char
ge a
fter
ded
uctib
le
No,
Char
ge ,a
fter
ded
uctib
le
Spec
ialty
Hig
h Co
st D
rugs
N
o Ch
arge
aft
er d
educ
tible
N
o Ch
arge
.aft
er d
educ
tible
£or D
educ
tible
Pla
ns: A
ll ,co
insu
ranc
e/co
pays
app
ly a
fter
ann
ual d
educ
tible
has
bee
n m
et. U
nle•s
s ot
herw
ise•
indi
cate
d +
2020
Cha
nges
-Hig
h D
educ
tible
H
ealth
Pla
n (H
DH
P) 0
08
35
2020
20
19
2020
20
19
2020
20
19
2020
Sil
ver D
educ
tible
Si
lver D
educ
tible
Si
lver D
educ
tible
Silv
er D
educ
tible
Si
lver
MEMB
ER
Silve
r Ded
uctib
le S
ilver
Ded
uctib
le
Silve
r Ded
uctib
le
009
(73)
009(
73)
009
(87)
009 (
87)
Dedu
ctibl
e 009
CO
ST SH
ARE
009
250%
FPL a
nd 0
09 25
0% FP
L and
00
9 (94
) ab
ove
abov
e 20
0-249
%
200-
249%
15
0-199
% FP
L and
150
-199%
FPL a
nd
100-1
49%
FPL
(94)
FPL a
nd ab
ove
FPL a
nd ab
ove
abov
e ab
ove
100-1
49%
FPL
Med
ical D
educ
tible
(indi
vidu
al/fa
mily
) $5
,ooo I
$10,
000
$5,o
oo I $
10,0
00
$2,5
00 /
$5,00
0 $2
,soo
/ $5
,ooo
N/A
N/
A
N/A
N/
A
Out-o
f-Poc
ket M
ax (i
ndivi
dual
/fam
ily)
$1,00
0 I $1
4,oo
o $7
,000 /
$14
,000
$6
,000
/ $1
2,000
$6
,000
/ $1
2,000
$2
,600
/ $5
,200
$2
, 700
/ $5
,400
$2,5
00 /
$5,00
0 $2
,500
/ $5
,000
MEDI
CAL
BENE
FITS
PCP
Offic
e Vi
sit
*$30
*$
30
*$30
*$
30
$20
$25
$10
$10
Spec
ialis
t Offic
e Visi
t $6
0 $6
0 $6
0 $6
0 $5
0 $5
0 $2
0 $2
0 Ou
tpat
ient
Facil
ity
30%
30%
30%
30%
20%
20%
10%
10%
Outp
atie
nt S
urge
ry 30
% 30
% 30
% 30
% 20
% 20
% 10
% 10
% Ur
gent
Care
Servi
ces
*$60
*$
60
*$60
*$
60
$50
$50
$20
$20
Ambu
lance
Ser
vice
s $6
0 $6
0 $6
0 $6
0 $5
0 $5
0 $2
0 $2
0 Em
erge
ncy R
oom
Serv
ices
30%
30%
30%
30%
20%
20%
10%
10%
Inpa
tient
Hos
pita
l Car
e 30
% 30
% 30
% 30
% 20
% 20
% 10
% 10
% In
patie
nt Sk
illed
Nur
sing F
acili
ty
30%
30%
30%
30%
20%
20%
10%
10%
Outp
atie
nt M
enta
l/Beh
avior
al/S
ubsta
nce A
buse
*$
30
*$30
*$
30
*$30
$2
0 $2
0 $1
0 $1
0 In
patie
nt M
enta
l/Beh
avior
al/S
ubsta
nce
Abus
e 30
% 30
% 30
% 30
% 20
% 20
% 10
% 10
% Ou
tpat
ient
Reh
abilit
ation
$6
0 $6
0 $6
0 $6
0 $5
0 $5
0 $1
0 $1
0 M
edica
l Imag
ing
(CT/P
ET Sc
ans/M
Rl's)
30
% 30
% 30
% 30
% 20
% 20
% 10
% 10
% Ro
utine
Lab/X
-Ray
/Diag
nost
ic Im
aging
$3
0 $3
0 $3
0 $3
0 $2
0 $2
0 $1
0 $1
0 PR
ESCR
IPTIO
N DR
UGS
Com
bined
Co
mbi
ned w
ith
Com
bined
with
Co
mbin
ed w
ith
Com
bine
d with
Co
mbin
ed w
ith
Com
bined
with
Co
mbin
ed w
ith
with
* P
resc
riptio
n Dr
ug D
educ
tible
(indi
vidu
al/fa
mily
) M
edica
l M
edica
l M
edica
l M
edica
l M
edica
l M
edica
l M
edica
l M
edica
l 90
day m
ail o
rder
supp
ly av
aila
ble a
t 2.5
x cop
ay)
Dedu
ctibl
e De
ducti
ble
Dedu
ctib
le
Dedu
ctibl
e De
ducti
ble
Dedu
ctib
le
Dedu
ctibl
e De
duct
ible
Ge
neric
*$
15
*$15
*$
10
*$10
$1
0 $1
0 $5
$5
Pr
efer
red
$70
$70
$50
$50
$45
$50
$20
$20
Non-
Pref
erre
d Br
and
$120
$1
20
$100
$1
00
$85
$85
$40
$40
Spec
ialty
High
Cos
t Drug
s 45
% 45
% 45
% 45
% 30
% 30
% 20
% 20
%
- * Ser
vices
are
exem
pt fr
om de
duct
ible
whe
re in
dica
ted (P
CP/S
pecia
list/U
rgen
t Car
e/Ge
neric
RX/
Men
tal-B
ehav
ioral
Hea
lth O
ffice
Visit
s)
r Fo
r Ded
uctib
le Pl
ans:
All c
oinsu
ranc
e/cop
ays a
pply
afte
r ann
ual d
educ
tible
has b
een m
et. U
nles
s oth
erw
ise in
dica
ted
2020
-Silv
er D
educ
tible
009
36
2020
: Ded
uctib
le U
pdat
es
• Im
port
ant:
• A
ll of
Com
mun
ity d
educ
tible
pla
ns h
ave
a co
mbi
ned
(Rx
+ M
edic
al) d
educ
tible
.
• P
CP
vis
its a
re n
ot s
ubje
ct to
ded
uctib
le fo
r all
plan
s ex
cept
Bro
nze
008
HD
HP
• S
peci
alis
t vis
its a
re n
ot s
ubje
ct to
ded
uctib
le fo
r all
plan
s ex
cept
Bro
nze
008
HD
HP
and
Silv
er 0
09
• U
rgen
t Car
e vi
sits
are
not
sub
ject
to d
educ
tible
for a
ll pl
ans
exce
pt B
ronz
e 00
8 H
DH
P
• G
ener
ic D
rugs
are
not
sub
ject
to d
educ
tible
for a
ll pl
ans
exce
pt B
ronz
e 00
8 H
DH
P
• B
ronz
e H
igh
Ded
uctib
le H
ealth
Pla
n is
HS
A c
ompa
tible
but
doe
s no
t hav
e an
inte
grat
ed
HS
A. C
onsu
mer
wou
ld n
eed
to e
nrol
l in
a se
para
te H
SA
pla
n (o
r use
an
exis
ting
HS
A
acco
unt)
37
2020
: Ded
uctib
le U
pdat
es
Plan
Nam
e M
edic
al
and
Rx
Dedu
ctib
le
Com
bine
d
Unl
imite
d PC
P vi
sits
be
fore
de
duct
ible
Unl
imite
d Sp
ecia
list
visi
ts
befo
re
dedu
ctib
le
Unl
imite
d M
enta
l He
alth
and
Su
bsta
nce
Abus
e O
ffic
e vi
sits
bef
ore
dedu
ctib
le
Gen
eric
s av
aila
ble
befo
re
dedu
ctib
le
Unl
imite
d U
rgen
t car
e vi
sits
bef
ore
dedu
ctib
le
001
(Gol
d Co
pay)
Go
ld 0
01 d
oes n
ot h
ave
a m
edic
al o
r Rx
dedu
ctib
le
003
(Bro
nze
Dedu
ctib
le)
004
(Silv
er
Dedu
ctib
le)
005
(Gol
d De
duct
ible
)
008
(Bro
nze
All s
ervi
ces s
ubje
ct to
ded
uctib
le
HSA)
009
(New
Silv
er
Dedu
ctib
le)
*Pre
vent
ive
serv
ices a
re n
ot su
bjec
t to
dedu
ctib
le o
r cos
t-sh
arin
g (F
or A
ll Pl
ans)
38
Cop
ay P
lan
• G
old
Cop
ay 0
01 is
the
only
rem
aini
ng c
opay
pla
n
• C
opay
s ap
ply
to a
ny c
over
ed s
ervi
ce fr
om d
ay o
ne
• In
patie
nt c
opay
s ap
ply
for t
he fi
rst f
ive
days
of
inpa
tient
sta
y
• S
peci
alty
hig
h co
st d
rugs
hav
e a
coin
sura
nce
39
2020
Pla
n Ch
ange
Sum
mar
y
• M
inim
al c
hang
es to
the
plan
des
ign/
mem
ber c
ost-
shar
ing
• A
ll of
the
cost
-sha
ring
chan
ges
wer
e m
ade
to
ensu
re p
lans
rem
ain
with
in th
e al
low
ed C
MS
met
al
desi
gnat
ion
• M
OO
PS
/Ded
uctib
les
upda
ted
per C
MS
regu
latio
ns
• C
ost-s
harin
g fo
r PC
P, S
peci
alis
t, La
bs, X
-rays
, U
rgen
t Car
e co
st-s
harin
g re
mai
ns th
e sa
me
as
2019
for a
ll bu
t one
pla
n
40
2020
Pla
n C
ross
wal
k
2019
Pla
ns
2020
Pla
ns
Gold
001
(Cop
ay)
Gold
001
(Cop
ay)
Silv
er 0
02 (C
opay
) Si
lver
004
(Ded
uctib
le)
Bron
ze 0
03 (D
educ
tible
) Br
onze
003
(Ded
uctib
le)
Silv
er 0
04 (D
educ
tible
) Si
lver
004
(Ded
uctib
le)
Gold
005
(Ded
uctib
le)
Gold
005
(Ded
uctib
le)
-
Silv
er Li
mite
d Ne
twor
k Pl
an 0
07 (C
opay
-Kel
sey
only
) Si
lver
004
(Ded
uctib
le)
Com
mun
ity H
ealth
Cho
ice
HMO
Bro
nze
008
High
Ded
uctib
le H
ealth
Pla
n-HS
A Co
mpa
tible
Co
mm
unity
Hea
lth C
hoic
e HM
O B
ronz
e 00
8 Hi
gh
Dedu
ctib
le H
ealth
Pla
n-HS
A Co
mpa
tible
Com
mun
ity H
ealth
Cho
ice
HMO
Silv
er 0
09
Com
mun
ity H
ealth
Cho
ice
HMO
Silv
er 0
09
Gold
001
(Cop
ay)
Gold
Lim
ited
Netw
ork
Plan
006
(Cop
ayKe
lsey
only
)
41
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ienc
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hone
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r mob
ile a
pp v
isits
. Set
up y
our a
ccou
nt to
day
so w
hen
you
need
cara
now
. a T
elad
ocdo
ctod
sjus
taca
ll o
r dic
k aw
ay.
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tern
al
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dic
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mil
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racti
ce
, o
r
Pe
dia
tric
ian
s
• P
ho
ne
Co
nsu
lta
tio
ns o
r V
ide
o
Co
nsu
lta
tio
ns a
va
ila
ble
• P
rovid
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n p
rescri
be
pre
scri
pti
on
me
dic
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on
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eg
iste
r a
nd
re
qu
est
a c
on
su
lt
42
CO
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UN
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mun
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ealth
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MO
C
om
m-l
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ealth
Cho
ice
HM
O
Com
m-l
ty H
ealth
Cho
ice
HM
O
Com
mun
ity H
ealth
Cho
ice
HM
O
Lean
Siv
er 0
09
Silv
er 0
04
Oolc
l 005
Oo
lcl 0
01
Plan
ID 2
7248
1X00
1000
9 Pl
an ID
272
481X
0010
004
Plan
ID 27
2481
X001
0005
Pla
n ID
272
48lX
0010
001
A=
Ban
d No
Tob
acco
T
.--
No T
obac
co
T.-
-No
Tob
acco
To
bacc
o No
Tob
acco
To
bacc
o 0-
14
203.
14
203.
14
210.
14
210.
14
277.
88
277.
88
292.
31
292.
31
341.
27
341.
27
352.
75
352.
75
15
221
.19
221.
19
228.
82
228.
82
302.
58
302.
58
318.
30
318.
30
371.
61
371.
61
384.
10
384.
10
16
228.
10
228.
10
235.
96
235.
96
312.
02
312.
02
328.
23
328.
23
383.
21
383.
21
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r:R
396.
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17
235.
00
235.
00
243.
10
243.
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321.
47
321.
47
338.
17
338.
17
394.
81
394.
81
408.
08
408.0
8 18
24
2.44
24
2.44
25
0.79
25
0.79
33
1.64
33
1.64
34
8.87
34
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60.00
Rate
s
Com
mun
ity is
ple
ased
to sh
are
that
our
pla
ns h
ave
eith
er re
ceiv
ed a
rate
pas
s or
43
rate
redu
ctio
n fo
r the
202
0 pl
an y
ear.
Ser
vice
are
a an
d N
etw
ork
44
Net
wor
k U
pdat
es fo
r 202
0
IMPO
RTA
NT
• A
LL p
lans
will
util
ize
the
Com
mun
ity n
etw
ork
of p
rovi
ders
• K
else
y-S
eybo
ld w
ill n
ot b
e pa
rt of
the
Com
mun
ity n
etw
ork
in 2
020
Not
e: A
ll m
embe
rs m
ust s
elec
t a P
rimar
y C
are
Phy
sici
an (P
CP
) or o
ne w
ill b
e as
sign
ed to
them
45
Plan
Ser
vice
Area
2020
Ser
vice
Are
a Ex
pans
ion
20 C
ount
ies
Aust
in
Mat
agor
da
Bra
zoria
M
ontg
omer
y C
ham
bers
N
ewto
n Fo
rt B
end
Ora
nge
Gal
vest
on
Polk
H
ardi
n Sa
n Ja
cint
o H
arris
Ty
ler
Jasp
er
Wal
ker
Jeffe
rson
W
alle
r Li
bert
y W
hart
on
CH
IP, S
TAR
, and
Mar
ketp
lace
pro
duct
s ar
e no
w o
ffere
d in
the
sam
e 20
-cou
nty
serv
ice
area
. (N
ew c
ount
ies
are
note
d in
re
d)
46
Com
mun
ity H
ospi
tal N
etw
ork
– B
aptis
t Hos
pita
ls o
f S
outh
east
Tex
as
– C
HI S
t. Lu
ke's
H
ospi
tal S
yste
m
– H
arris
Hea
lth
Sys
tem
–
HC
A H
ospi
tal
Sys
tem
–
Hou
ston
Met
hodi
st
Hos
pita
l Sys
tem
–
Hun
tsvi
lle M
emor
ial
Hos
pita
l
– Li
berty
Day
ton
Reg
iona
l M
edic
al C
ente
r –
Mem
oria
l Her
man
n H
ospi
tal S
yste
m
– K
indr
ed H
ospi
tal S
yste
m
– O
akbe
nd M
edic
al C
ente
r –
St.
Jose
ph M
edic
al
Cen
ter
– Th
e M
edic
al C
ente
r of
Sou
thea
st T
exas
–
UTM
B H
ealth
Sys
tem
–
Win
nie
Hos
pita
l
47
2020
Anc
illar
y N
etw
ork
Upd
ates
• R
x m
ail-o
rder
ven
dor:
Kro
ger
• E
nvol
ve V
isio
n (o
nly
child
ren
18 a
nd u
nder
)
• C
omm
unity
Hea
lth C
hoic
e B
ehav
iora
l Hea
lth S
ervi
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(form
erly
B
eaco
n H
ealth
Str
ateg
ies,
effe
ctiv
e Se
ptem
ber 2
019)
• Te
lehe
alth
– p
rovi
ded
by T
elad
oc-N
ot a
vaila
ble
for H
DH
P-H
SA
pla
n m
embe
rs
• N
ovu
-Wel
lnes
s P
rogr
am V
endo
r-W
elln
ess
and
Eng
agem
ent P
rogr
am
• R
outin
e de
ntal
ser
vice
s ar
e no
t cov
ered
by
Com
mun
ity. E
nrol
lees
hav
e th
e op
tion
to p
urch
ase
stan
d-al
one
dent
al p
lans
offe
red
by o
ther
com
pani
es
thro
ugh
the
Mar
ketp
lace
or o
n th
eir o
wn
48
Com
mun
ity R
ewar
ds
• 20
20 W
elln
ess
and
Eng
agem
ent P
rogr
am
• M
embe
rs c
ompl
ete
heal
th re
late
d ac
tiviti
es a
nd
rece
ive
$25
gift
card
s
• M
ust a
ctiv
ate
by p
hone
or m
embe
r por
tal
• A
ttest
to c
ompl
eted
act
iviti
es
• R
ecei
ve g
ift c
ard
via
mul
tiple
opt
ions
incl
udin
g e-
gift
card
s
49
~N
ITY
RE
W..-
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2020
Wel
lnes
s an
d En
gage
men
t Act
iviti
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• 20
19 F
lu V
acci
natio
n-$2
5 •
2020
Ann
ual W
elln
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Vis
it-$2
5 •
2020
Rea
d &
Ear
n M
odul
es-$
25
• 20
20 E
nrol
men
t in
Aut
o-P
ay-$
25
• 20
20 B
onus
for c
ompl
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g A
LL a
ctiv
ities
-$25
* N
ot a
ll m
embe
rs w
ill q
ualif
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r eac
h ac
tivity
. Inc
entiv
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portu
nitie
s m
ay v
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base
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age
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gram
for ch
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unde
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age o
f 21 w
ho qu
aLify
and f
or pre
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ho ca
nnot
afford
healt
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COMM
UNIT
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PLAC
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ariety
of in
dividu
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alth
CCl.\l
\fl.J1
'Tn'
insura
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IIEAl
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Marke
tplace
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Pro
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t the
FIN
D A
DOCT
OR H
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Page
, sel
ect “
Nex
t”
Step
2: S
elec
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Mar
ketp
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Pla
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51
SELEC
T YOU
R PLA
N
Yoor
~al!h
Plan
* Ycu
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STAR
No-co
st heal
th ins
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pro
gram
for chi
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under
the
age of
21 wh
o qua
lify an
d for
pregna
nt wom
en wh
o cann
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rd hea
lth ins
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.
Ill
C.OMM
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SKIP
GUID
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r Sea
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3: E
nter
a Lo
catio
n Th
is ca
n be
an
addr
ess o
r a zi
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52
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Step
4: S
elec
t the
pro
vide
r typ
e yo
u ar
e se
arch
ing
for a
nd th
en “S
earc
h”
Step
5: R
evie
w o
r cha
nge
sear
ch
crite
ria in
cludi
ng:
Plan
Pr
ovid
er
Loca
tion
Mile
age
Prov
ider
Typ
e Ex
pand
ing/
Sear
chin
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s No
vem
ber 1
, 201
9!
54
On
Exch
ange
-
• O
n E
xcha
nge
enro
llmen
t can
be
com
plet
ed th
roug
h yo
ur b
roke
r por
tal,
via
ww
w.H
ealth
care
.gov
dire
ct o
r by
phon
e at
1.8
00.3
18.2
596
• E
nrol
ling
On
Exc
hang
e is
the
only
way
a p
erso
n ca
n ge
t tax
cre
dits
to h
elp
pay
for t
heir
prem
ium
s
• In
divi
dual
s re
ceiv
ing
tax
cred
its M
UST
file
an
inco
me
tax
retu
rn
• O
n E
xcha
nge
plan
s in
clud
e th
e C
ost S
harin
g R
educ
tion
plan
s (C
SR
pla
ns)
– S
ilver
73%
, Silv
er 8
7%, a
nd S
ilver
94%
(can
not g
et O
ff Ex
chan
ge)
• O
n E
xcha
nge
plan
s al
so in
clud
e Ze
ro a
nd L
imite
d C
ost S
harin
g pl
ans
avai
labl
e to
mem
bers
of f
eder
ally
reco
gniz
ed tr
ibes
or A
lask
a N
ativ
e S
ettle
men
t Act
Cor
pora
tion
shar
ehol
ders
(can
not g
et O
ff Ex
chan
ge)
55
Off
Exch
ange
• O
ff E
xcha
nge
plan
s ar
e th
e sa
me
as th
e O
n E
xcha
nge
stan
dard
B
ronz
e, S
ilver
, and
Gol
d pl
ans
• N
o C
SR
(73/
87/9
4) o
r Lim
ited/
Zero
Cos
t Sha
ring
plan
s ar
e av
aila
ble
Off
Exch
ange
• A
pply
thro
ugh
fax
in a
pap
er a
pplic
atio
n th
at is
ava
ilabl
e on
line
• O
pen
Enro
llmen
t dat
es a
re th
e sa
me
as O
n Ex
chan
ge a
nd
Spe
cial
Enr
ollm
ent P
erio
d cr
iteria
is th
e sa
me
as O
n E
xcha
nge
• A
ccou
nt s
ervi
cing
(inc
ludi
ng c
hang
e of
info
rmat
ion,
add
ing
depe
nden
ts, e
tc.)
will
go
thro
ugh
Com
mun
ity, n
ot C
MS
56
Ren
ewal
s N
otic
e
• C
omm
unity
mem
bers
cur
rent
ly e
nrol
led
in a
201
9 pl
an w
ill
rece
ive
two
notic
es re
gard
ing
2020
cov
erag
e:
1.
One
from
Com
mun
ity o
utlin
ing
2020
pre
miu
ms
and
bene
fit
chan
ges
– M
aile
d on
Oct
ober
4, 2
019
2.
One
from
CM
S e
xpla
inin
g th
e op
en e
nrol
lmen
t pro
cess
• If
a cu
rren
t mem
ber t
akes
no
actio
n, th
e m
embe
r will
“p
assi
vely
rene
w” i
nto
a 20
20 C
omm
unity
pla
n
• M
embe
rs in
the
Silv
er C
opay
002
and
Lim
ited
Net
wor
k P
lans
00
6 &
007
will
be
cros
s w
alke
d in
to a
noth
er C
omm
unity
pla
n
• If
a cu
rren
t mem
ber t
akes
act
ion
and
upda
tes
thei
r ap
plic
atio
n on
Hea
lthca
re.g
ov th
en th
ey w
ill n
eed
to s
elec
t a
2020
pla
n
57
Pol
icy
Upd
ates
Whe
n a
polic
y up
date
is n
eede
d, p
leas
e ed
it th
e ex
istin
g ap
plic
atio
n ve
rsus
sub
mitt
ing
a ne
w
appl
icat
ion
Exa
mpl
es:
• A
ddin
g de
pend
ents
•
Rem
ovin
g de
pend
ents
•
Upd
atin
g in
com
e •
Upd
atin
g de
mog
raph
ics
58
Who
is e
ligib
le to
enr
oll?
• An
y in
divi
dual
resi
ding
in o
ne o
f Com
mun
ity’s
20
coun
ty s
ervi
ce a
rea
and
thei
r el
igib
le
depe
nden
ts
• E
ligib
le d
epen
dent
s in
clud
e:
– S
pous
e –
Bio
logi
cal c
hild
ren
unde
r th
e ag
e of
26
– S
tepc
hild
ren
unde
r th
e ag
e of
26
– A
dopt
ed c
hild
ren
unde
r th
e ag
e of
26
– Fo
ster
chi
ldre
n un
der
the
age
of 2
6 –
Bro
ther
or
Sis
ter (
child
onl
y po
licie
s)
– Li
fe p
artn
er
(chi
ldre
n up
to a
ge 2
6 ar
e co
vere
d th
roug
h th
e en
d of
the
year
)
• Fa
mili
es w
ith m
ore
than
3 c
hild
ren
enro
lled
on th
e sa
me
polic
y un
der
the
age
of 2
1 ar
e ch
arge
d fo
r th
e fir
st th
ree
child
ren
only
. Chi
ldre
n ag
e ba
nds
incl
ude:
0-1
4, 1
5, 1
6, 1
7, 1
8, 1
9, 2
0 –
e.g.
Fam
ily e
nrol
lmen
t rec
eive
d:
• Fa
ther
– c
harg
ed a
pplic
able
rat
e fo
r age
ban
d •
Mot
her
– ch
arge
d ap
plic
able
rat
e fo
r age
ban
d •
Chi
ld a
ge 1
0 –
char
ged
0-14
rat
e •
Chi
ld a
ge 6
– c
harg
ed 0
-14
rate
•
Chi
ld a
ge 4
– c
harg
ed 0
-14
rate
•
Chi
ld a
ge 2
– n
o ch
arge
59
Wel
lnes
s D
isco
unt
• 10
% p
rem
ium
redu
ctio
n w
ill c
ontin
ue to
be
offe
red
in 2
020
• P
rogr
am d
etai
ls w
ill fo
llow
via
em
ail
com
mun
icat
ion
60
FAQ
’s
• N
ewbo
rns
mus
t be
adde
d to
a p
olic
y to
hav
e ac
tive
cove
rage
–
If on
-exc
hang
e ne
wbo
rn s
houl
d be
add
ed w
ith H
C.g
ov
– If
off-e
xcha
nge
new
born
sho
uld
be a
dded
with
Com
mun
ity
• C
ance
llatio
ns/te
rmin
atio
ns re
quire
writ
ten
docu
men
tatio
n si
gned
by
the
mem
ber (
pref
erab
ly a
n ap
plic
atio
n ch
ange
/term
form
)
• PC
P c
hang
es a
re e
ffect
ive
first
of t
he fo
llow
ing
mon
th
• In
ord
er to
pro
vide
spe
cific
cla
ims
info
rmat
ion,
you
r clie
nt m
ust
com
plet
e a
HIP
AA
aut
horiz
atio
n fo
rm a
llow
ing
you
acce
ss
• C
hild
onl
y po
licie
s or
pol
icie
s w
here
an
indi
vidu
al o
ther
than
the
subs
crib
er w
ants
to b
e au
thor
ized
for p
olic
y in
quiri
es m
ust h
ave
an
HIP
AA
auth
oriz
atio
n fo
rm o
n fil
e
61
Key
Date
s Re
min
der
Nove
mbe
r 1, 2
019
Open
Enr
ollm
ent B
egin
s
Dece
mbe
r 15,
201
9 La
st o
fficia
l day
of o
pen
enro
llmen
t
Janu
ary
1, 2
020
2020
Hea
lth C
over
age
Begi
ns
62
Nex
t Ste
ps
• C
ompl
ete
CM
S tr
aini
ng
• Ta
ke C
omm
unity
Qui
z &
Sub
mit
to
Age
nt.C
rede
ntia
ling@
Com
mun
ityC
ares
.com
•
Com
plet
e th
e Tr
aini
ng A
ttest
atio
n an
d su
bmit
to
Age
nt.C
rede
ntia
ling@
Com
mun
ityC
ares
.com
•
Sub
mit
any
mis
sing
pap
erw
ork
– N
ew A
gent
s: A
gree
men
t, BA
A, W
9 –
Ret
urni
ng A
gent
s: U
pdat
ed D
emog
raph
ic/C
onta
ct
info
rmat
ion
incl
udin
g E
mai
l, U
pdat
ed W
9 (if
ne
cess
ary)
, Upd
ated
E&O
Cer
tific
ate
(if e
xpire
d),
Qui
z &
Atte
stat
ion
63
Que
stio
ns
Plea
se se
nd a
ll qu
estio
ns in
an
emai
l to
Agen
t.Cre
dent
ialin
g@Co
mm
unity
Care
s.c
om
Plea
se b
e su
re to
list
the
Subj
ect o
f the
Em
ail a
s: Su
bjec
t: W
ebin
ar Q
&A
In th
e bo
dy o
f you
r em
ail b
e su
re to
in
clude
any
que
stio
ns y
ou h
ave.
64