Open Call
Name, Date of Birth, Complete Address, Social Security Number, or Application ID
What is Disclose
What are essential health benefits included in each plan? Relevant Script (Essential Health Benefits)
The premium tax credit is a federal tax credit that _______ through the Marketplace. It’s based on the
What is lowers the cost of your health insurance premium?
If you’re ending coverage for only some people on your application, coverage can end immediately or at the end of the month. This will depend on if the remaining applicants qualify for a special enrollment period when we make changes to your application. If you’re ending coverage for everyone on your application, you can choose to end it today or pick a future end date
When should I end coverage? Can I pick a future end date?
Business process, Information Accuracy, and Privacy and Disclaimers are the three.
What is compliance category's
This script is used when The consumer needs to authorize another individual, or if the caller doesn’t pass disclosure
What is Authorization and Disclosure Script?
What are preventive and wellness services included in each plan? (Relevant Script-Preventive and Wellness Services)
It’s based on the:
What is
Depending on the updates you make to your application, your premium, deductible, or any copays or coinsurance you’ve paid towards your annual out-of-pocket limit may reset. The updates may also change how much financial help you can get.
What could happen when I end coverage for someone on my application?
Applying tools to provide complete information to callers
What is Issue Resolution
This Applet is used for any active Consumer messages.
What are Consumer Indicators?
For adults, plans aren’t required to offer dental coverage.
For children, age 18 and younger, plans must offer dental coverage either as part of a health plan or as a stand-alone dental plan. While it must be offered, it’s up to the consumer to decide if they want to buy dental coverage for their children. The consumer should verify this information with their plan before enrolling.
Do plans include dental coverage? (Dental Coverage)
You can claim it when you________ or ________ to lower your monthly premium payments.
What is claim it when you file your taxes, you can use it in advance to
You can check your coverage status in the My plans & programs section of your HealthCare.gov account.
Can I get confirmation that my coverage has ended?
Controlling the call and handling caller issues effectively
What is Call Efficiency
After you pass the disclosure, you ask the consumer
Which state do you need health coverage information for?
What types of health plans are offered by the Marketplace?(Types of Health Care Plans)
If you choose to use it in advance, the Marketplace will send your ____________ and __________ using Form 8962, Premium Tax Credit. You must do this even if you normally aren’t required to file taxes because of your income.
What are advance payments directly to your insurance company, and you must reconcile your tax credits
If you want to keep your Marketplace coverage and remove someone from coverage, we'll need to report a life change on your application. To avoid any gaps in coverage, it’s best to wait until you know the exact date that their Medicare coverage will begin before ending their Marketplace coverage.
What is Someone in my household is going to Medicare
Demonstrating an understanding of the caller’s needs and using effective probing questions to understand the caller’s issue if necessary
What is Active Listening
18
What is the number of states that have their own Marketplace?
What are the plan categories, and what percentage of services used will the consumer pay? (Plan Categories)
The Marketplace uses information from your application to determine
What is your expected contribution
If you’re eligible for full-benefit Medicaid or CHIP, you won’t be eligible for Marketplace coverage with financial help, and you’ll have to pay the full cost of the plan. If you’re eligible for limited-benefit Medicaid or CHIP, this isn’t considered qualifying health coverage so you may still qualify for Marketplace coverage with financial help.
Can I keep my Marketplace coverage if I have Medicaid or CHIP?
Being aware of the caller’s personality and circumstances so that you can adapt your personality accordingly
What is Personality Flexing