Case Type
Case Narrative
HICS Search
Disposition
Acronyms
100

Consumer reported the policy start or end date is incorrect or missing. 

What is a Policy Start/End Date?

100

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.

100

The HICS Search tool offers a variety of search criteria to find additional cases related to the current case. 

True/False?


True

100

Used when consumer's request for changes on their Form 1095-A is not supported

What is Denied?

100

What does HIOS stands for?

Health Insurance Oversight System

200

Consumer is requesting for a mailing address correction. 

What is a Mailing Address Update (MAU)?

200

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 

200

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

200

Used when the Mailing Address Update being requested is reflected in the FFM data

What is a Reprint Request?

200

What does FFM stands for?

Federally-Facilitated Marketplace

300

Consumer reported that the monthly premium amount is incorrect. 

What is a Monthly Premium Amount?

300

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 

300

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

300

Used when the Mailing Address Update being requested is not reflected in the FFM data

What is a Mailing Address Update?

300

What is HIPAA?

Health Insurance Portability and Accountability Act of 1996

400

Consumer reported error on the 1095-A form regarding the Monthly Advanced Premium Tax Credit (APTC) amount. 

What is a Monthly APTC Amount?

400

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

400

When using the HICS Search tool, multiple searches should be completed to ensure a thorough research effort is made.

True / False? 

True

400

Used when specific information cannot be obtained to understand the dispute.

What is Not Enough Information

400

What is APTC?

Allocated Advance Premium Tax Credit Amount

500

Consumer reported they never received a 1095-A form. 

What is a Missing 1095-A?

500

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. 

500

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. 

500

Used when the consumer's claim is denied but updates still need to be submitted.

What is a Denied with Discrepancy?

500

What is PACO?

Post-Analysis Consumer Outreach (PACO)