Taxes and the Marketplace Jeopardy

Tax Forms

100

The date of birth on my Form 1095-A is wrong, can you get that corrected for me?

Form 1095-A is intended to help you fill out Form 8962 when you file your taxes. The correction you have identified is not information you need corrected on Form 1095-A to complete Form 8962. Just enter the correct information when you complete your tax forms. I can also update this information on your current Marketplace application so that it will be correct in the future.

200

If a consumer is reporting a complex Form 1095-A issue, such as an incorrect policy or individual start date or incorrect termination date, what should you do?

Use Form 1095-A HICS escalations script to transfer to Tier 2

300

What tax form is used to claim an exemption?

Form 8965

400

What form is used to claim advanced payments of the premium tax credit?

Form 8962

500

Can you mail me a copy of my voided Form 1095-A?

You can find a copy of your voided 1095-A form in your Marketplace account under the Your Inactive 1095-A forms section. You must select the appropriate application for the tax filing year first and select the Tax forms link on the left side of the page. Voided forms are for reference only and are not for tax filing purposes. You should use the form(s) in Your Active 1095-A forms section to complete Form 8962 when filing your taxes. If you don’t have a Marketplace account, you can visit HealthCare.gov and create one.

Complex Form 1095-A Issues

100

How long does it take for a consumer to receive a notification for an address mailing correction for their Form 1095-A?

14 business days

200

Which of the following would be a Tier 2 transfer: The consumer was enrolled in coverage for only part of the month as reflected in the APTC OR the issuer name on the Form 1095-A is incorrect?

The issuer name on the Form 1095-A is incorrect

300

Can you update the address on the 2017 application in order for the consumer to receive a 2016 Form 1095-A?

No

400

Which of the following would be a Tier 2 transfer: The consumer had a stand-alone dental plan or dental coverage for children not reflected in the PTC on Form 1095-A OR individuals are missing on the Form 1095-A or incorrectly listed.

Individual are missing on the Form 1095-A or incorrectly listed

500

When would you use the Mailing Address Correction section of the Form 1095-A HICS escalation script?

Use the Mailing Address Correction table to submit a Health Insurance Casework System (HICS) escalation if a consumer’s Form 1095-A was sent to the wrong address and they don’t need to make any other types of corrections. If a consumer needs corrections made to their Form 1095-A, refer to the Form 1095-A Complex Research Requests section.

Exemptions

100

How many ways can a consumer apply for an exemption?

Two - through the Marketplace and through the IRS

200

How long does it take to receive the exemption eligibility letter after applying for an exemption?

If your exemption application is complete, it usually takes about 30 days from the time you mail your application to the Marketplace to receive your exemption eligibility letter in the mail.

300

I am waiting on my exemption number to arrive from the Marketplace but it is April 18 and I need to mail my taxes out tonight. What should I do?

If you mailed an exemption application to the Marketplace and are still waiting for a decision when you file your tax return, follow the instructions with your tax return and enter “Pending” in the appropriate places. If you apply for the exemption directly from the IRS using Form 8965, you won’t need an ECN.

400

A consumer has received a letter asking for more information to complete the exemption application. What does a CSR need to do?

Submit an escalation and select for Q1 Answer: Exemption Escalation and for Q2 Answer: Consumer received a letter asking for more information for the exemption application.

500

Which of the following will probably not receive an exemption from either the Marketplace or IRS: Members of a health care sharing ministry or fans of Duke Basketball

Duke Basketball

Disclosure

100

On a three way with an agent and consumer, can you say the name of either the agent or consumer before either have passed disclosure and/or been authorized? Why or why not?

No. When you are talking with an agent remember that when the consumer is brought in on the line that the consumer must pass disclosure before you speak the consumer’s name.

200

Can you give any kinds of hints to a consumer if they are not able to provide their correct date of birth?

No

300

If a non-consumer is not authorized or the authorization has expired what should you do?

What is Read completely from the Authorization and Disclosure script the following: Unfortunately, I am unable to access specific information about this consumer for you today. The consumer that you are calling on behalf of must provide the Marketplace with a verbal authorization to allow us to release information about his or her account. The verbal authorization allows you to access the information the consumer designates without the consumer being present on the phone. If you have any general questions about the Marketplace, I am happy to help you.

400

If an agent only wants to give her first name and first initial of her last name, how long can the authorization be for?

Valid for that day

500

For authorization purposes, what is a "consumer"?

For authorization purposes, a “consumer” is anyone on the application over age 18, which includes: •Individuals seeking coverage through the Marketplace, and •The individual filing the application (the application filer), who may or may not be seeking coverage.