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ENROLLING IN A QHP (QUALIFIED HEALTH PLAN) FFM QUESTIONS WITH 100% CORRECT ANSWERS!!
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ENROLLING IN A QHP (QUALIFIED HEALTH PLAN) FFM QUESTIONS WITH 100% CORRECT ANSWERS!!
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ENROLLING IN A QHP (QUALIFIED HEALTHPLAN) FFM QUESTIONS WITH 100% CORRECT
ANSWERS!!
Enrollment Answer - Enrollment is the process of signing up for a qualified
health plan (QHP).
Eligibility determination Answer - Before enrolling in a QHP offered through
the Marketplace, consumers must obtain an eligibility determination from the
Marketplace by submitting an application.
Enrollment periods Answer - After their eligibility has been determined,
qualified individuals may enroll in a QHP during the annual Open Enrollment
period, or during an Special Enrollment Period (SEP)s for which they are
eligible. SEPs occur throughout the year based on consumers' special
circumstances.
Marketplace Pathway to Application Answer - In this pathway, registered
agents/brokers help a customer obtain an eligibility determination & select a
plan directly at HealthCare.gov. The consumer creates an account, logs into the
site w/a consumer account, and "drives" the process; the agent/broker does
not log in to HealthCare.gov. Generally, the Marketplace Pathway requires
agents/brokers to be sitting side by side with the consumer because the
consumer must sign in to HealthCare.gov without sharing their login
credentials.
Enhanced Direct Enrollment (EDE) Pathway to Application Answer - In this
pathway, agents/brokers affiliated with approved QHP issuers or web-brokers
, (referred to as "approved partners") have the ability to assist individuals in
applying for and enrolling in Marketplace coverage directly from the QHP
issuer's or web-broker's website. Approved partners may provide the full one-
site experience for the application, enrollment & post-enrollment support on
their own websites, without the secure redirect to & from the HealthCare.gov
website. They may customize the Marketplace application, as long as they do
not alter the substance of the application, potentially simplifying/streamlining
the questions that consumers are asked. Through secure data transfers, the
Marketplace will determine a consumer's eligibility for QHP coverage,
Medicaid, or CHIP, as well as the applicable APTC & CSR amounts.
Classic Direct Enrollment (DE) Pathway to Application Answer - In this pathway,
registered agents/brokers affiliated with QHP issuers or web-brokers use the
double redirect to connect to HealthCare.gov through the QHP issuer's or web-
broker's website to submit the consumer's application & get an eligibility
determination from the Marketplace & if the consumer is eligible, then return
to the QHP issuer's or web-broker's website to select a QHP.
Note: Assisting consumers over the phone Answer - Agents/Brokers can only
assist consumers with the application process using EDE or DE when assisting
by phone.
Other ways to submit a Marketplace Application: Paper Answer - Paper
applications may be submitted by mail. Visit HealthCare.gov to download a
paper application & instructions.
Other ways to submit a Marketplace Application: Phone Answer - In the event
consumers encounter technical problems when using HealthCare.gov,
agents/brokers may conduct a three-way, toll-free call with the consumer & the
Marketplace Call Center. Services are available in 150 languages.
Agents/brokers should either use the Marketplace Pathway, or work with the
applicable classic DE or EDE partner first before contacting the call center for
enrollment assistance.
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