2. Pre-Screening Process – Eligibility Determination and Shopping
Ability for consumers to browse for qualified health plans (QHPs) and check eligibility anonymously for Medicaid and advanced premium tax credits (APTC) without creating an account
Optional tool
No account needed
Results not saved
Potential eligibility based on minimum
information entered by the individual (including
age, gender, and household income)

3. Single Stream-Lined Application Process
Only one application required to apply for a QHP or Medicaid
Eligibility determination based on data entered by consumer
Validation of client entered data via federal hub and other state systems
Once the applicant’s information is verified, the system will display the “Programs You Qualify for Screen”
Applicants using paper applications need only fill out one application

4. Integrated Exchange and Medicaid Eligibility System
Qualified Health Plans with/with out APTC
Medicaid for families and childless adults using Modified Adjusted Gross Income (MAGI) – (eligibility determined based on income)
Non-MAGI Medicaid Programs (2015) – Aged, blind and disabled (eligibility based on income and resources)

5. Lessons Learned
Insufficient number of Customer Service Representatives and phone lines for call center.
Initial server capacity problems due to unanticipated interest and demand on kynect web site.
kynectors and agents played a valuable role in enrollment.
With marketing and outreach, and a simple and easy designed
website, they will come and enroll.
Agents did not have the right tools to enroll small
employers in SHOP.

6. Priorities for 2015 Adding more CSRs and phone lines for call center
Marketing focus on early renewals and individuals eligible for APTC but not enrolled
Implementing an Issuer Portal
Releasing kynect app
Applying potential eligible APTC amounts
to premiums for QHP plan browsing functionality
Revamping SHOP