Enroll
What does a cancelled plan mean?
Plan was never started or never active
When the carrier sees member's status as enrolled, but VIM does not, what ticket is needed?
Enrollment Not Found Ticket
VIM
Virginia's Insurance Marketplace
What script is used when a customers' call comes in red, blank or no color?
Inbound Call Greeting/ Red Name/ Blank / No color
When a call comes in, what screen should be used to access the customer's account?
Caps pop up
What does Terminate mean?
To end a plan after at least one day of coverage.
When the customer has lost coverage and wants their coverage restored, what ticket is needed?
Reinstatement ticket
SEP
Special Enrollment Period
What script is used for calls that come in GREEN?
Inbound Call Greeting/ Green Name
Name one place to look if customers plan has been cancelled.
Applications, Account Activity, Member view/My Applications
What does it mean if a plan is pending?
Carrier has not confirmed payment yet
When the customer has resubmitted an application, but the APTC is not showing for all of the months that should be included, what ticket is needed? .
Apply APTC Request
LOA
Lack of Authentication
What script is used when you cannot hear a customer?
Silent Caller Script
Where can you look to see all members of a household.
Member view/ My application, Member view dashboard and Member view/ Eligibility Results
Who is considered to be in a Household?
Everyone included when filing taxes
The customer calls in stating they have Medicare effective 3/1/2024 and it is now 4/15/2024, what ticket is needed?
Backdate Termination Request
CSR
Cost Sharing Reductions
What script used when calling a customer?
Outbound script.
Where to look to see if customer qualifies for APTC or CSR?
My Applications, My Eligibility results, Dashboard, Eligibility Notice in Inbox
After Identifying the customer from Members/Manage Members tab, where would you find if customer is enrolled in a plan?
App. Status
All workarounds have been done and customer's account is still not showing correctly, what ticket is needed?
System Error/Technical Issue
EDI
Electronic Data Interchange
What do you need to verify a customer on the outbound call.
Full Name, Full Address with zip code and DOB.
Where can you find the Member ID number
Enrollments/Additional information