1. Application and Enrollment Process for Healthcare
Application and Enrollment Process for Healthcare.gov November 10, 2016
Hello My name is Ruby Piscopo and I am the O&E coordinator for WVPCA

2. How the Marketplace Works
Create an account
Apply
Pick a Plan
Enroll
I am going to walk you through the steps of Healthcare.gov. I will show you how to create an account. How to fill out the application. Comparing and picking a plan and how to enroll in the the policy of the consumers choosing. Now…

3. Take 5
Find a partner
Spend 2 or 3 minutes describing some of the challenges you have encountered so far in the enrollment process.
Before I begin today I’d like to learn from you about your experience so far with this enrollment period. I’d also like to give you a chance to network and learn from each other. So, for the next 5 minutes, I’d like to invite you to find a partner in the room, (outside of your organization) and each of you spend two or three minutes describing some of the challenges you’ve encountered so far in your work, what questions have been raised for you, what are you struggling with.
I will let you know when time is up.
At the end of your conversations, I would like to hear from a few of you, something perhaps you and your partner had in common. This will really help me during my presentation to ‘keep it real’ for you guys.

4. Creating an Account Choose a user name and password.
Get started by entering some basic information, like the name, address, and .
Choose a user name and password.
Create and answer security questions for added protection.
Your username will be your ..
Quick Tip
*If the consumer does not have an make them one and make the pw the same.
*You may want to write your answers down and keep them in a very secure place so you don’t forget them.
IT will send a conformation once you get this click on the link and it will read “account successful”

5. Application Process Consumer agrees to the privacy policy.
Fill in all contact information.
Choose how the consumer wants to receive notices.
“contact information” pretty straight forward. TIP* The first is along the side- It actually shows the steps you will take through out the process. The second is at the bottom of the screen; This is for those consumers you had to make an for. There is an option to opt out of getting notices sent to your . They can get these notices sent to there mailing address.

6. Do you need help paying for coverage?
Who helped you apply for coverage?
The next part will ask if someone is helping the consumer apply for coverage. So if it is you just fill in your information. If they don’t need help paying for coverage (APTC) it will automatically take them to Family &Household. I am going to show you how to do the help paying for coverage. Important tip* if the consumer is not seeking financial assistance make sure you select no. It will make the process much faster.

7. Who needs Coverage?
On this screen you will choose who needs coverage. If the consumer you are helping don’t need coverage but there children do then you would select “ other family members”. Example: if the husband has VA benefits and he is applying for the rest of his family then he would select “other members” In this case I am putting myself and my dependent need coverage. I push add a person and it will ask me for the name DOB and relationship.

8. Household Information
On this Screen it will ask if you are married, filing income tax, and ethnicity. If you are applying for more then one person it will ask you this information for each individual. Important tip between each section it will do a summary of all the information you gathered. It is always nice to go over it all again. This will save you time in the end.

9. Income Information
Marketplace savings are based on expected household income for the year coverage is wanted.
Income is counted for themself, spouse if married, and everyone they will claim as a tax dependent on federal tax return.
If you marked you need help paying for coverage as I did you will have to report all income. As you can see there is a drop down box so depending how the consumer gets paid you can add it accordingly. It will ask this for each individual applying for coverage. There is a list of income you do and do not add on the screen before this. It will also ask if they pay any deductions. Such as student loans, Alimony, ect.

10. Additional Information
The additional information is basically asking if you have had a life changing events. It will ask about insurance, getting married/divorced, having a child ect.

11. Review and Sign
At this point you will review the whole application with the consumer change any information that may be wrong. Read the Statements and agree and have the Consumer type in there name. * A little tip I print this screen once the consumer agrees to the statements.
Ok, the applying part is finished.

12. Eligibility Notice
Once the application is completed, you’ll get an eligibility notice that explains what the consumer qualifies for. It'll provide appeals instructions for each person in the household, including the number of days they have to file an appeal.
The Eligibility Notice will tell you everything you qualify for. So if this was Special Enrollment time this would tell you if you qualify. Looking at this it tells us this consumer is eligible to purchase through the MP/ he qualifies for tax credit and cost sharing reductions. This notice also allows you to the next steps the consumer needs to take. In this example it is showing they need more information. The pages after this will tell the consumer exactly what they will need to upload. It will give them a list of qualifying documents.
In this example It would need proof of income. So on the pages following it would have a list of examples including 1040 tax return, w2, pay stubs etc.. It also will say how long they have to turn in these documents.

13. Choosing your tax credit
After Reading you Eligibility notice you will then start enrolling. As you can see there is an Enroll list. The first is to set you Premium tax credit. The consumer can take all some or none of there tax credit. It will allow you to set it to whatever the consumer decides; you then will use that amount.

14. Household Question
Here it will ask about all individuals enrolling in health insurance about tobacco use. If the consumer chooses yes it will ask the last day of use. I have had people look at me crazy and say well 10 mins ago. This is the only question they ask that will affect the premium.

15. Choosing a plan
Metal categories are based on how the plan splits the costs of health care. They have nothing to do with quality of care.
This is the screen that initially comes up. As you can see there is a section at the top to only select that tier. So if someone was getting a cost sharing and they knew they only wanted a silver plan. You could only select only silver . Some consumers may only want gold or silver again just select those two.

16. Compare, Save, Enroll
A couple different options on this screen. You can compare different plans by checking compare. I believe you can compare 3 different plans at a time. It compare prices premiums, deductibles, coinsurance/ copay, and the benefits those plans have. You can also save the plan. Lets say the consumer is not ready to pick one today they want to go home and show there significant other. They could just select save. You also see you can push details and it will show you everything that plan has to offer, And of course you can enroll in that plan by pushing enroll.

17. Upload Documents
If the consumer decides to save the plans when they sign back in all they would select is resume enrollment. It will take them right back to the plans they saved. Once you select upload documents it takes you to your files to upload. It is very simple.
Important Tip: Upload the documents do not mail them in unless absolutely necessary

18. Exemptions
Hardships are life situations that keep you from getting health insurance. If you qualify for a hardship exemption, you don’t have to have health insurance or pay a fee for the months the exemption applies.
To claim a hardship health coverage exemption, you must fill out a paper application and mail it to the Health Insurance Marketplace.
If the consumer is granted an exemption they would sign into there account and choose exemption and add the certification number. This will allow them to purchase a catastrophic plan if they choose.

19. Ruby Piscopo 304-346-0032 Ruby.Piscopo@wvpca.org www.wvpca.org
Contact Information
Ruby Piscopo