CUSTOMER NEED
A customer wants to know if they qualify for Health Connector coverage.
What is Eligibility?
A customer wants to sign up for coverage for the first time.
What is Member Application?
A customer needs their tax form from the Health Connector.
What are 1095 Forms?
A customer is having trouble with a computer or technical feature.
What is Tech Support?
A customer wants to ask about a decision they disagree with.
What are Appeals?
A customer needs to prove who they are before moving forward.
What is ID Proofing?
A customer wants to look at different health plans and compare their options.
What is Plan Shopping?
A customer needs help with a bill or making a payment.
What is Billing & Payments?
A customer has questions about dental coverage that is not part of the Health Connector's HIX system
What is Non-HIX Dental?
A customer needs help because they are having a difficult financial situation and may qualify for special consideration.
What is a Hardship Waiver?
A customer simply has a question and isn't sure which category they need.
What is General Inquiry?
A customer wants to make a change to their current enrollment.
What is Enrollment Change?
A customer wants a copy of a notice, bill, or other document.
What is Fulfillment?
A customer says, “The website isn't working for me!”
What is Tech Support?
A customer is contacted as part of a special Health Connector outreach effort.
What is Outreach – Restricted?
A customer needs help with a special request related to accessibility.
What are Accommodations?
A customer had coverage that ended and wants to get it started again.
What is Reinstatement?
A customer wants to know how to get their 1095 form.
What are 1095 Forms?
A customer has a question about dental coverage that needs to be handled outside of HIX.
What is Non-HIX Dental?
A customer wants to appeal something they believe is incorrect.
What are Appeals?
A customer wants to report something that has changed in their situation.
What is Report a Change?
A customer is trying to figure out whether they qualify for coverage before choosing a plan.
What is Eligibility?
A customer says, “I need another copy of something you sent me.” Which workflow should you think of first?
What is Fulfillment?
Name both workflows in this category.
Tech Support and Non-HIX Dental.
A customer asks about a special waiver because of a hardship. Which workflow should you select?
What is a Hardship Waiver?