Case Type
Consumer reported the policy start or end date is incorrect or missing.
What is a Policy Start/End Date?
Coverage termination date is wrong on consumer's Form 1095-A. Kim Welch can be reached at (123) 456-7890. The consumer's application ID is 1847174570. The correct end date is 12/31/2019. The incorrect end date on the form is 05/31/2019. Affected individual: Kim Welch DOB: 09/19/1987 SSN: 123114567.
What is Policy End Date?
Note: Kim is reporting about her policy end date or coverage termination date.
The HICS Search tool offers a variety of search criteria to find additional cases related to the current case.
True/False?
True
Used when consumer's request for changes on their Form 1095-A is not supported
What is Denied?
What does HIOS stands for?
Health Insurance Oversight System
Consumer is requesting for a mailing address correction.
What is a Mailing Address Update (MAU)?
Monthly Premium amount is wrong on consumer's Form 1095-A. Lilia Gallardo can be reached on (703) 225-7669. The consumer's application ID is 1813134853. The correct monthly premium is $850.00. The incorrect monthly premium amount on the form is $844.07. Affected individual: Lilia Gallardo DOB: 01/01/1995 SSN:444112345.
What is a Monthly Premium Amount?
Note: Lilia is reporting about her total monthly premium amount
What does the HICS Search tool allows analysts to search for?
Plan and Issuer Concerns Cases (P&I cases),
Other Medicaid/CHIP Eligibility cases,
Correlated cases
Used when the Mailing Address Update being requested is reflected in the FFM data
What is a Reprint Request?
What does FFM stands for?
Federally-Facilitated Marketplace
Consumer reported that the monthly premium amount is incorrect.
What is a Monthly Premium Amount?
Mailing address correction for Form 1095-A. Noemi Alvarez can be reached at (987) 654-2310. The consumer's application ID is 4532949696. Consumer requests a new copy of be sent to 222 EagleEye Parkway, ID 11111. Exchange Assigned Policy ID 35523011. Affected Individual: Noemi Alvarez
What is a Mailing Address Update?
Note: Noemi is reporting about her Mailing Address Update
Mention any two of the Search by criteria when using the HICS Search tool.
App ID
Case ID
First Name
Last Name
State
HIOS ID
Phone Number
Used when the Mailing Address Update being requested is not reflected in the FFM data
What is a Mailing Address Update?
What is HIPAA?
Health Insurance Portability and Accountability Act of 1996
Consumer reported error on the 1095-A form regarding the Monthly Advanced Premium Tax Credit (APTC) amount.
What is a Monthly APTC Amount?
Consumer does not have an FFM account and did not receive Form 1095-A but insists that they had Marketplace coverage. Sylvia Zapata can be reached at (345) 478-2345. Affected individual: Sylvia Zapata DOB 01/01/1994, SSN: 979613456. The policy start/end date are 01/01/2019 - 12/31/2019. Exchange Assigned Policy ID 23403556.
What is a Missing 1095-A Form?
Note: Sylvia is reporting a missing 1095-A form
When using the HICS Search tool, multiple searches should be completed to ensure a thorough research effort is made.
True / False?
True
Used when specific information cannot be obtained to understand the dispute.
What is Not Enough Information
What is APTC?
Allocated Advance Premium Tax Credit Amount
Consumer reported they never received a 1095-A form.
What is a Missing 1095-A?
APTC amount is wrong on consumer's Form 1095-A. Saida Deanda can be reached at (571) 895-2758. The correct APTC amount is $920. The incorrect APTC amount on the form is $240. Affected individual: Saida Deanda DOB: 05/13/1998 SSN:123456789. Exchange Policy ID 31740852. Consumer had coverage from 03/01/2019 - 12/31/2019.
What is a Monthly APTC Amount?
Note: Saida is reporting about the monthly APTC amount on her form.
The HICS case number criteria is the best option to use when looking up information about other related cases.
True / False?
False
Note: The HICS case number criteria is used when looking up information about a specific case.
Used when the consumer's claim is denied but updates still need to be submitted.
What is a Denied with Discrepancy?
What is PACO?
Post-Analysis Consumer Outreach (PACO)