Privacy & Disclosure
Nemo calls in on behalf of his father Marlin and Nemo is not on the application what are the first FOUR MAIN STEPS that we do? (Hint: Phase 1: Receive the call)
1. Search for Marlin's record
2. Open the call record
3. Pass disclosure (Log scripts)
4. Check for authorization
Mirabel calls in and she starts speaking Spanish. What do you do?
Say "Un momento, Por Favor" and transfer to a Spanish- Speaking CSR
What are the five plan categories?
Bronze, Silver, Gold, Platinum, and Catastrophic
Carol and Ellie call in because they are about to be eligible for Medicare soon. They both have Marketplace. What's a good probing question to ask them?
When does your Medicare start?
Who must you put on the application when applying for insurance?
Everyone on the household taxes
Mickey Mouse called in for Minnie Mouse, and you see that his authorization is expired to speak on her behalf. What do you do?
Ask to speak with Minnie Mouse to add/update the authorization.
A consumer is speaking another language other than Spanish, What can you do?
Connect to the language Line
Mulan calls in and says she lost her employer health coverage, what will we do to help her?
Update the application/Report a life change to report a loss of coverage
Ellie's Medicare starts soon but Carol has another year before he is eligible for Medicare. What do you do to help Mrs. Ellie?
Update the application for Ellie's medicare start date.
If you see an assentation language, What must you do? (2 Steps)
Read it word for word and make sure that the consumer agrees to the language.
If Mickey Mouse cannot get Minnie Mouse on the phone to update his authorization, what would you tell Mickey?
I cannot assist you in accessing your wife's account. Please call back when she is available.
If a consumer has more than one insurance through the marketplace for the year, Will he only receive one 1095-A Form?
No; he will receive multiple.
Where do we go to look what documents a consumer submitted?
The Documents view on the FFM Contacts screen
Prince Eric calls the marketplace because he lost his job and Ariel no longer has coverage anymore. What can you do to help them?
Create in English application to see if they qualify for in SEP
Fiona calls in for her son and wants coverage for him. Her son is on a lot of medications. She is also looking for the most cost-sharing plan. What can you do to help narrow her plan results? (2 answers)
Apply filters to cover her son's medications. Then select silver plans.
Peter Pan called in and wants to update his information. What three fields would we ask from Peter to find his record?
First name, Last name, Date of birth (DOB)
If a consumer has in incorrect SSN on her 1095-A, what can you do to help?
She can correct her SSN on her Form 8962
What Reference Material can we pull up to review a copy of a letter that the plan/insurance sent to the consumer?
Plan-Specific Letters reference material
Which button would you press if a consumer's income fluctuates?
Monthly Calculator/Estimator Tool
After enrolling Tinker Bell in a health plan, What other option can you offer her?
Ask if she would like to enroll in dental coverage
If you cannot get their First name, last name, and/or DOB. What other information can we get from Peter Pan? (2 pieces)
His application ID and state
If a consumer forgot to update her address with the marketplace but she needs a copy of her 1095-A, what can you do to help?
Submit a HICS to send it to her new address
Cruella calls in stating that she got a letter from her plan that states it doesn't cover the services she needs and gave her the option to enroll in a different plan. What script would we use to help Cruella?
Plan-Specific Issues (Letter Received) script
How long does a consumer have to resolve their SEP verification issue?
30 days
Where would you go to see the status of a DMI issue associated with the specific application?
DMI status field on the FFM individual Application Detail Screen DMI view