Call Flow
What are the best fields to search for a consumer?
First Name Last Name D.O.B
What button would you use in the Plan Compare tool to see if the consumer doctor is covered?
Add Filter Button
How long does the marketplace gives a consumer to resolve a DMI?
Generally, 90 Days depending on the DMI
What script should you always start with when a consumer is expressing difficulties with their plan.
Plan Issues Script.
How long does a SEP last for?
60 days from the qualifying life event.
If the Name, DOB and state do not work to find the consumer what is the next preferred method?
Application ID and State
After selecting a consumer's health plan what is the next step?
Ask about a separate dental plan
True or False. A consumer can regain coverage after updating their application due to an expired DMI - Citizenship.
FALSE
A consumer states what they are being billed by their old plan. After doing research this is a new plan issue how should we help this consumer?
HICS Escalation
Which SEP has a different coverage timeline than 1-15th= Next Month 16th - 31st = Month after next?
Birth of a Child or Adoption of a Child
You see Johnny Smith (All info matches) on both the FFM consumers and NGD Contact list applets when pulling up his account what should you do?
Merge
What tool would you use to help consumers determine their income when it is hard to predict?
The Monthly Calculator.
Citizenship/Immigration Status
After researching a consumer's missing enrollment, they paid their plan, it has been over 2 weeks, it is outside of OEP and they do not have a SEP on file what should we do?
Transfer to Tier 2
A consumer states that they called 3 weeks ago to complete their application when they had a baby but was sent to medicaid. She is calling back today because medicaid denied her. How can we help this consumer?
Update the application with the medicaid denial
A husband calls on behalf of his wife to get her 1095A form. What probing questions should you ask this caller?
Are you an applicant on her application or the application filer?
A consumer calls in to apply for coverage and wants to know if she should add her 17-year-old niece and nephew who she takes care of. What script should you use to help this consumer?
Application Process
Where should you go to see why we sent a document to a consumer?
FFM Contacts Screen > Documents View
What script do we end up in when helping a consumer with a letter they received from their plan about wrong information displayed in healthcare.gov or their plan is ending?
Plan Issues (Letter Received) Script
A consumer calls to report her husband is now eligible for coverage at his job but she needs to keep her coverage. What should you ask this consumer?
When does your husband employer coverage starts?
An agent calls in on behalf of a consumer but the authorization is expired how would you assist this agent with a DMI?
Ask to speak with the consumer
Finish this sentence. The plan compare tool is only unlocked ________
During OEP or when a consumer has a SEP.
Where should you go to see all the DMIs on a consumer's application?
FFM Individual Application Detail Screen > DMI View
Where can we see a copy of the letter a plan sent the consumer when it affected the marketplace consumers as a whole?
Plan-Specific Letters reference material.
A consumer calls in to report she was just married. What should you do first?
Check messages to see if her account was already FLAGGED with a SEP