Terms
Action you can take for a consumer that no longer needs Marketplace coverage.
What is end their Marketplace plan/coverage?
Where can you see a consumers Eligibility Determination Notice.
What is the Documents View?
A way to find health coverage that fits consumers budgets and needs, helps consumers figure out if they qualify for public health coverage programs like Medicaid and CHIP.
What is the Marketplace?
November 1st - January 15th
What are the dates for the Marketplace Open Enrollment Period?
A consumer from France tells you he doesn't speak English well. Use this script.
What is connecting to the Language Line?
First Name, Last name, DOB
The proper way to search a Consumer or contact record
Melissa and Elisa's favorite football Team
What is the Green Bay Packers?
Consumers between the ages of 19-65, may now qualify for this based on income and family size.
What is Medicaid?
QSEHRA
what is a qualified small employer health reimbursement arrangement?
A consumer can fill this out when the social security number isn't correct on the 1095-A or they need to reconcile their APTC.
What is Form 8962?
Checking the boxes for at least 3 pieces of information to pass this process.
What is disclosure?
You can find SOP CC 3.53.01 in this script.
What is Procedure for Suicide or Crisis Call
The largest Health Insurance program in the United States
What is the Centers for Medicare and Medicaid Services (CMS)
To qualify for this you must have a household income of less than or equal to 250% of FPL, receive premium tax credit and enroll in a silver plan through the marketplace
What is cost sharing reductions?
Steps you take for a consumer who receives a letter stating they were denied Medicaid.
What is update the consumer’s application to report the Medicaid coverage denial?
You can merge records from these 2 list applets
What are the FFM Consumers and NGD Contacts list applets
Melissa's favorite color
What is the color chartreuse?
Health Maintenance Organization
What is an HMO?
Where should you go in NGD to see the status of all data matching issues associated with the application?
What is the DMI Status field on the FFM Individual Application Detail screen DMI view?
The fields that should be updated in the Activities List applet (2 items), on the FF Contacts Screen, Applications View
What are the Caller Relationship and Language Field?
Application ID and State
Alternate way to search a Consumer or Contact
You must do this before your plan starts/effectuates
What is pay your first Premium