Privacy & Disclosure
Nemo calls in on behalf of his father Marlin and Nemo is not on the application, What must we do? (Four Steps)
1. Search for Marlin's record
2. Open the call record
3. Pass disclosure
4. Check for authorization
Mirabel calls in and she starts speaking Spanish. What do you do?
Say "Un momento, Por Favor" and transfer to a Spanish- Speaking CSR
If a consumer has more than one insurance through the marketplace for the year, Will he only receive one 1095-A Form?
No: he will receive multiple.
Carol and Ellie call in because they are about to be eligible for Medicare soon. They have Marketplace. What's a good probing question to ask them?
When does your Medicare start?
Who must you put on the application when applying for insurance?
Everyone on the household taxes
Mickey mouse called in for Minnie Mouse and you see that his authorization is expired to speak on her behalf. What do you do?
Ask to speak with Minnie Mouse to add/update the authorization.
A consumer is speaking another language other than Spanish, What can you do?
Connect to the language Line
If a consumer doesn't like the Results of the EDN, What can they do?
Appeal
Ellie Medicare starts soon but Carol has another year before he is eligible for Medicare. What do you do to help Mrs. Ellie?
Update the application for Ellie's start date.
If you see an assentation language, What must you do? (2 Steps)
Read it word for word and make sure that the consumer agrees to the language?
If Mikey Mouse cannot get Minnie Mouse on the phone to update his authorization, What would you tell Mickey?
I cannot assist you in accessing your wife's account. Please call back when your wife is available.
Where can you see what other language a consumer speaks?
In the Consumer Form Applet
Stitch called in saying he got a letter about being enrolled into a different plan because old plan is no longer available. What script would we use to help this consumer?
Plan- Specific Issues (Letter Received)
Prince Eric calls the marketplace because he lost his job. and Ariel no longer has coverage anymore. What can you do to help them?
Create in English application to see if they qualify for in SEP
Fiona calls in for her son and wants coverage for him. Her son has a weak immune system and is on a lot of medications. She is also looking for the least expensive plan. What can you do to help narrow her plan results? (2 answers)
Apply filters to cover her son's medications. Then select silver plans.
Peter Pan called in and wants to update his information. What three fields would we get to find his record?
First name, Last Name, DOB
If a consumer has in incorrect SSN on her 1095-A, what can you do to help?
She can correct her SSN on her Form 8962
If you are talking to an authorized individual, What do you update in the activities field? (2 Fields)
Caller Type and Caller Relationship
Which button would you press if a consumer income fluctuates?
Monthly Calculator/Estimator Tool
After enrolling Tinker Bell in a plan, What other option can you offer them?
Ask if she would like to enroll in dental coverage
If you cannot get their First name, last name, DOB. What else can you get from Peter pan?
His application ID and state
If a consumer forgot to update her address on their 1095-A, what can you do to help?
Submit a HICS for them to send it to her new address
Where do we go to look what documents a consumer submitted?
The Documents view on the FFM Contacts screen
How long does the consumer have to Resolve their SEP verification issue?
30 days
Where would you go to see the Status of a DMI issue associated with the specific application?
DMI status field on the FFM individual Application Detail Screen DMI view