Abbreviations
What does ACA stand for?
What is Affordable Care Act?
What are the different levels of Plans?
Jake calls in for ACA enrollment but at the present time he does not work but is looking for work? Does Jake still qualify to enroll? and why?
What is Yes! He still has an expectation of income by the end of the year!
Do you have to file a tax return in order to enroll in ACA coverage?
What is: Yes, for the next 5 years
Jillian wants to apply for ACA coverage but is married to Junior. What is the first question you ask Jillian?
What is: How do you file your taxes?
What does CSR stand for?
What is cost sharing reduction.
What level plan are CSR's used on only?
What is Silver!
For dependents who are not seeking coverage do you have to list their Social Security Numbers?
What is: No/ because they are not obtaining coverage, we do not need their social.
Does your deductible count towards your out-of-pocket max?
What is Yes!
Jacob wants to apply for ACA coverage but during the application it comes back that he has Tri Care or VA Insurance? Will he still be able to enroll in ACA coverage?
What is Yes but at full price without any APT credit!
What does SEP stand for?
What is Special Enrollment Period.
What is Out of Pocket Max?
What is: the most a customer can spend out of pocket towards insurance excluding the monthly premium.
Greg a college student calls to enroll in ACA coverage. He is enrolled in school full time, but his parents still claim him on their taxes! However, he works a pt. time job and files taxes every year! May he enroll? if so, does he go on his own application or need his parents' information?
What is: Yes/ still needs parents' information!
Do some plans have an Rx deductible?
What is: Yes
Jamilla lost her subsidy due to missing income verification documentation! Can she get her subsidy back? How?
What is yes. As long as documentation is provided, and flag is caught within 30days of expiration date and application maintained.
What does MAGI stand for?
What is Modified Adjusted Income.
What are acceptable forms of income documentation?
What is: Tax return/ 1044/ 2 most recent paycheck stubs, self-payroll information.
Jamella is 18 and wants to register for ACA coverage. She is a US citizen, but her parents are not! Can she still apply for ACA coverage? Why?
What is: Yes/ because she is a US citizen parents just can't apply.
On every ACA plan this is automatically included for children under 18!
What is: Pediatric Dental
Ms. Graham has Medicare part A may she still apply for ACA coverage? If so, will she still receive her full subsidy amount?
What is Yes, and Yes
What does PII stand for?
Personal Identifying Information
What are the qualifying events that make people eligible to enroll outside of OE period?
What is: Death, Birth, Marriage, Loss of Health Coverage, Recent jail release, moved more than 100miles within 30 days
Ms. Magi lost her subsidy due to verification documentation. She didn't notice until 2 months after they took her subsidy away! Can she still stay enrolled in her current plan without paying the unsubsidized premium?
What is: No / she would have to pay what she owes in order to stay in same plan! If she cannot afford to pay, she may switch carriers.
This level of coverage is always the best option for people under 200% of FPL.
What is: Silver
Marie receives $850.00 a month for her subsidy. But she is not 100% sure about her income due to self-employment what can Marie do to make sure she doesn't owe when she files her taxes at the end of the year?
What is: alter the amount of her subsidy she chooses to use.