Data Matching Issues
Income/Citizenship DMI's
1095-A Form
Tax Questions
Miscellaneous
100
What is the name of the script you use to help a consumer resolve a DMI?
Resolving Data Matching Issues
100
Name 5 documents a consumer can submit to resolve an Income DMI.
Federal or state 1040 tax return Wages and tax statement like a W-2 and/or 1099 Pay stub Social Security Administration statements Self-employment ledger Unemployment benefits letter
100
What is the name of the script you use to answer 1095-A questions?
Form 1095-A and Marketplace Tax Questions
100
Where can you find the consumer's Second Lowest Cost Silver Plan if it is not on their 1095-A Form?
You can locate the tax tool online by searching for “tax tool” at HealthCare.gov.
100
What script should you use if a consumer asks about Trump and if the ACA is going to change?
2017 Presidential Administration and Supreme Court Decisions
200
What is a Data Matching Issue?
A data matching issue happens when the information you include on your application doesn’t match what we found in our records.
200
What documents can a consumer send in to provide proof of Citizenship without needing a second document?
•U.S. passport •Certificate of Naturalization (N-550/N-570) •Certificate of Citizenship (N-560/N-561) •State-issued enhanced driver’s license, which are available in Michigan, New York, Vermont, and Washington •Document from a federally recognized Indian tribe that includes your name and the name of the federally recognized Indian tribe that issued the document, and shows your membership, enrollment, or affiliation with the tribe. Documents you can provide include:◦A tribal enrollment card ◦A Certificate of Degree of Indian Blood ◦A tribal census document ◦Documents on tribal letterhead signed by a tribal official
200
Where does the consumer get their form 1095-A?
Your Form 1095-A comes from the Marketplace and not from your health insurance company or the Internal Revenue Service. You should receive Form 1095-A in the mail no later than mid-February, but it may be available in your HealthCare.gov account earlier.
200
What is the name of the form the consumer uses the 1095-A to fill out?
Form 8962
200
Should you check messages on every call even if the consumer does not pass disclosure?
Yes!!
300
How do you check the status of a DMI?
Navigate to the DMI view in NGD to check the status of the consumer's DMI.
300
What do I do if my coverage was terminated for not providing proof of my Citizenship?
You may be able to get Marketplace coverage again if you submit documents that resolve your issue. When your issue is resolved, you can enroll in coverage again through a special enrollment period.
300
If the consumer's 1095-A has the wrong coverage dates how do you fix it?
Complete a Tier 2 Transfer.
300
When is the deadline for filing your 2016 taxes?
Tuesday April 18th 2017
300
How long does it take for an insurance company to receive a new enrollment?
It can take up to 2 weeks.
400
Can a consumer get an extension on their DMI request? If so how?
Yes. To submit a request for an extension you must complete a HICS escalation requesting for an extension.
400
What do you do if a consumer lost their tax credit because they didn't send in proof of their income before the deadline?
Help update the consumer's application with the correct income to see if they are eligible for a tax credit going forward.
400
If the consumer's name, DOB, or SSN is incorrect on their 1095-A what should you do?
Nothing. Form 1095-A is intended to help consumers fill out Form 8962 when they file taxes and is for informational purposes only.
400
Should a consumer file their taxes before receiving their form 1095-A?
No. Filing before you receive this form may delay your refund, if you are eligible for one.
400
If a consumer says they have an Urgent Medical Situation but does not have active coverage should you complete an Urgent HICS escalation?
No. The consumer must have active coverage.
500
How does a consumer submit documents to resolve their DMI?
A consumer can upload their documents on their account online or they can mail them in.
500
If the consumer qualifies for a tax credit when completing the update is their tax credit reinstated retroactively?
No.Consumers who are eligible for a tax credit aren’t eligible to have it reinstated retroactively.
500
What is the only Read All script in NGD? When would you use it?
Reading Form 1095-A. Use this script to provide Form 1095-A information over the phone to the consumer if the consumer does not have a copy of their form, can’t access it online, and does not want to wait for a reprint of their form to be mailed to them.
500
How can a consumer apply for an exemption?
There are 2 ways you can apply for an exemption: •You can claim most exemptions using Form 8965, “Health Coverage Exemptions,” through the Internal Revenue Service, when you file your tax return. •You can apply for other exemptions through the Marketplace by filling out a paper exemption application and mailing it to the Marketplace.
500
What are the 10 Essential Health Benefits?
•Ambulatory services, like doctor or clinic visits •Emergency services •Hospitalization, like overnight stays at the hospital •Maternity and newborn care, like pregnancy and delivery •Prescription drugs •Laboratory services, like tests and blood work •Preventive and wellness services and disease management •Pediatric or children’s services, including dental and vision care •Mental health and substance use disorder services, including behavioral health treatments •Rehabilitative and habilitative services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills
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