•Health Insurance Casework System (HICS) escalations will take approximately_____ to complete.
What is 30 Days.
100
This is the first script that should be accessed when following all DMI resolution paths.
What is "Resolving Data Matching Issues"
100
According to the "What Is Form 1095-A?" section of the Form 1095-A and Marketplace Tax Questions script, the 1095-A is sent to consumers who had Marketplace coverage for all or some part of last year so those consumers can complete this.
What is Their Federal Income Tax Return.
100
These have to be checked, read if applicable, and a sub-activity logged on each and every call.
What are Consumer Messages.
100
The acronym NGD stands for ________ _______ _______.
Next Generation Desktop
200
When assisting a consumer with an issue they are experiencing with their plan, there are primarily two scripts that should be accessed in order to ensure the escalation is completed correctly. The two scripts are __________ and __________ .
What are...
Plan Issues and Escalate Plan Issues.
200
What DMI DISPOSTION WOULD THIS BE?
We’re still reviewing your documents and we’ll contact you if we need additional information or if we have questions. There’s no need to send the same documents again.
What is HOLD
200
This script is used this script to provide Form 1095-A information over the phone to the consumer if the consumer does not have a copy of their form, can’t access it online, and does not want to wait for a reprint of their form to be mailed to them.
What is the "Reading Form 1095-A" script
200
This script is used to assist consumers who have questions about ending their health coverage for all or some of the members of their household, or whose plan is ending their coverage.
What is "Ending Marketplace Coverage"
200
Welcome to the User ______ Task. Your ________ is important, and it often helps to track areas of improvement.
What is User Feedback
300
The Consumer has a cost-sharing amount (deductible, coinsurance, out-of-pocket limit) that does not match the amount they saw in Plan Compare
What is Cost-Sharing Discrepancies.
300
At the Top of the Resolving Data Matching Issues script in the CSR Note section there are a list of hyperlinks that will direct you to the appropriate section or script. This link will take you the "Submitting Documents to Resolve Data Matching Issues" script.
(Hint: There are two correct answers.)
What is
1. How do I submit documents to resolve my data matching issue?
or
2. What documents do I need to submit to resolve my data matching issue?
300
Your Form 1095-A comes from the Marketplace and not from your health insurance company or the Internal Revenue Service. You should receive Form 1095-A in the mail no later than mid-February, but it may be available in your HealthCare.gov account earlier.
What is
Where Can I Get Form 1095-A
300
The _________ is sometimes known as the medical loss ratio, or MLR. This _____helps keep costs down for the consumer. Consumers may receive a rebate from their insurance company because of this ____.
What is
80/20 Rule
300
You can locate important updates in what section of NGD?
What is Home (User Alerts)
400
Consumer’s health plan has not provided requested plan materials in ____, large print, CD, or another language.
What is Consumer needs assistance obtaining plan materials in braille, CD, large print, or another language.
400
This happens if a consumer hasn't filed there taxes yet and needs to submit documents.
What is Can I Get An Extension To Submit My Documents.
400
It’s possible that the Form 1095-A that you received from the Marketplace doesn’t include information about your ___________________, or that this information is outdated.
What is The Second Lowest Cost Silver Plan.
400
When you visit ___________, you will be able to easily locate helpful information about the Health Insurance Marketplace, how it can benefit you, and how you can buy and use health insurance.
To send a paper application to a consumer, what section of NGD must you go to?
What is Print Fulfillment
500
If a consumer experiences one of these following issues what escalation would this be?
•Their application was deleted.
•They had an exceptional circumstance, such as a medical emergency or a natural disaster, which prevented them from previously terminating coverage.
•They previously requested to terminate their Marketplace coverage but their request was not processed (this does not include someone who doesn’t realize it takes 14 days to terminate).
What is Can I Get a Retroactive Termination Date if I Wasn’t Able to End My Marketplace Coverage Before I Enrolled in Other Health Insurance
500
The following natural disaster(s) have been approved for an extension to submit documentation.
What is Flooding In Louisiana
500
•Consumer believes they had coverage through the Marketplace but did not receive a Form 1095-A. The consumer does not have a Form 1095-A online and there is no record of the consumer having coverage through the Marketplace.
What is
Form 1095-A Complex Research Requests
500
If you would like to apply for a _____________ through the Marketplace and a member of your household is not applying for a ________, you’ll have to submit 2 applications.
What is Catastrophic Plans.
500
How many pieces of disclosure can you get total from a consumer in NGD?