2Presentation format:Type your question in the GoToMeeting “Questions” area located in the toolbar on your right side of the screenIf time allows, the Moderator will answer the questions verbally at the end of the presentationThere will not be a live Q&A sessionThis webinar is being recorded and will be posted 30 minutes after the presentation at
5QuestionsI spoke with a provider yesterday that is in the BCBSTX HMO network, but they are not taking the Advantage HMO network. Therefore when you are online and doing a HMO provider search on BCBS and the provider is indicated to be in the HMO network it may not really be indicating that they will take the HealthCare Reform plans. Therefore if you enroll someone in an HMO network then they will have even more limited network than what is implied on the BCBS website.
6On Exchange – Complete Option A Off Exchange – Complete Option B TrainingACAYou ARE required to take the Marketplace Certification if you are working “On Exchange” (helping your clients apply for tax subsidies/cost sharing).You Are Not required to take the Marketplace Certification if you are working “Off Exchange” (clients are enrolling without tax subsidies/cost sharing).BCBSTXYou ARE required to complete the Marketplace Matters training on the BCBS website if you are selling “On or Off Exchange” plansOn Exchange – Complete Option AOff Exchange – Complete Option BCompletingYou ARE required to send in training forms to BCBS regardless of which option you are selling. All certification instructions can be found on our website at under Products/Individual Major Medical
7Submission Deadlines 3/1/2014 4/1/2014 5/1/2014 Effective Dates Apps must be submitted no later than 2/15/144/1/2014Apps must be submitted between 2/16/14 and 3/15/145/1/2014Apps must be submitted between 3/16/14 and 3/31/14March 31st is the final deadline to submit business until November 15, 2014 for a effective date (QEP excepted).
8Qualifying EventsHe loses minimum essential coverage, including through divorce.He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption or foster care.He becomes a citizen, national or lawfully present individual.He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer, employee or agent of the Marketplace.The plan he enrolled in substantially violated a material provision of its contract with the individual.He becomes newly eligible for premium tax credits or cost-sharing assistance.He becomes ineligible for premium tax credits or cost-sharing assistance.He makes a permanent move and has access to new health plans.He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans one time each month).He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him for special enrollment.When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a health insurance plan or change plans.
9Short Term Major Medical Critical IllnessHospital IndemnityAccidentNeed Answers forAfter Lock In?Here Are Your Solutions!
10Based on full premium, not subsidized premiums Commission6% - Years 1-34% - Years 4 +Based on full premium, not subsidized premiumsPaymentBCBS will be releasing commissions for January 1, 2014 effective dates between February 18 – 20th
11Snapshot Bonus Program On 11/30/13 BCBS take a snapshot of your business for small group and individual business.On 5/1/2014 BCBS takes a 2nd snapshot of your business.The difference between the two snapshots will receive $50 per app up to $25,000.
12Agent Assignment Confirmation Form Fill out the Agent Assignment on all applications submitted to BCBS to make sure you are recognized as the Agent of RecordSend your forms to
13Now you are at Blue Access for Producers Understanding Your Producer PortalLogin toClick on Producer TabEnter your Username and PasswordNow you are at Blue Access for Producers
14Use Your Producer Portal To Access Product and FormsProduct Overviews, Comparison Charts, Dental InformationMarketing and SalesAdvertising Materials, Compensation SchedulesTraining and AdministrationAccess the Market Place Matters TrainingOther InformationLegislative UpdatesProvider FinderCommission Statements
15Use your Quote and Enroll button to quote Off Exchange Applications Use your Quote and Enroll button to quote Off Exchange Applications. You can save and your quotes when quoting Off Exchange. Generate a formal proposal and your clients can enroll from the you send.Online BAP
16Individual ToolsUse your Express Link Button when quoting On Exchange Applications.You will need to copy and paste your Express Link into a new internet browser if you are working on the quote.You can also your Express Link to your client and let them do the work
17Individual ToolsUse your Track Application Status button to track applications and find out the status of your clients.
19Key Points to RememberWhen Quoting On The Exchange Be PreparedMake sure your clients have all information needed to go to the MarketplaceNames, Birthdates, Household Income, Social Security NumbersMake sure you have your FFM & NPN numbers to enter in Healthcare.gov.Consumers Need To Create Their Own Usernames and PasswordsAgents will be out of compliance if creating for their clientsMake sure your client records their usernames and passwords as they will need them at a later date.Eligibility ResultsMake sure your clients either print or save the results letter for future use.
20Put in your client information Your Express LinkPut in your client information
21If you select yes you will then have the option to either get an estimate or get an official tax credit amount
35Market Place – More Information Once identity questions are verified you will be prompted to enter household information and income amount.After all information is entered the eligibility results will be availableOpen the pdf to view the eligibility results and either save and or print the letter for your clients. They will need to keep this information for tax purposes.Find the Return to Issuers Website button to return to the BCBS website.After returning to the BCBS website tax subsidies and/or cost sharing will reduce the premiums and benefits in order for your client to determine which plan to enroll in.
43Or you can have the client sent a bill for the premium Credit card option will take you to a 3rd party vendor (May charge $9.99 for this service in the future.)Or you can have the client sent a bill for the premium
44Applicants signatures There will be a button here that you will click to submit the application
45Checking Status on your Business! For Underwriting Status and other New Business formsOpen your web browser and visitClick on the button labeled "Producer Services".Click on the button labeled "Register".Complete the simple form being sure to provide your Tax ID (SSN or EIN) and your BCBS writing number listed above in this . Once you have completed the form, click "Continue".You will receive a notice stating that you should check your to validate your account.Check your and look for a message. Follow the instructions contained in the , clicking the link to validate your account.After validating your account, you will receive a message stating that "You have successfully validated your address and account. Please log in." Click the "log in" link.
49Things to Know about Dental Plans Pediatric dental is required to be offered on all ACA Plans.Consumers can add a stand alone dental plan from Blue Cross Blue ShieldDental follows the same open enrollment period as medical
56HealthCare.gov Enrollment Things To KnowProvider IssuesProviders not accepting plans get name and phone of providers office and send toPremium PaymentsEFTPay By MailPay in PersonCredit/Debit Card OptionCheck By PhonePayment DeadlinesBCBSTX Clients have until 2/28/14 to pay their January and FebruaryHealthCare.gov EnrollmentClients that enrolled directly on the exchange can only make changes by contacting The Marketplace.
57Important News From The Marketplace System Maintenance Will Affect Feb. 15 Applications On Feb. 15, the Social Security Administration (SSA) is taking down its website for regularly scheduled systems maintenance activities.This will affect people applying for coverage on the healthcare.gov site, since eligibility verification with the SSA is part of the application process.Applications for March 1 coverage will need to be submitted before 2 p.m. CT in order to find out if the applicant qualifies at the time of application.Any applications received after 2 p.m. will be processed beginning on Tuesday, Feb. 18.
59Other Resources BCBS Agent Support Line – 855-782-4272 Market Place Call Center –Market Place Agent Support –Medicaid – Medicaid.govCHIP – 877-KIDSNOW
60Find valuable tools in our Individual Health section at www Find valuable tools in our Individual Health section at
61Q & A To ask a question, type your question in the GoToMeeting Q&A box If we cannot answer all questions with certainty, we will include the answer in our follow up, after additional research has been doneAll answers during this segment will be provided as a follow up to you via .