WebEx Training

Friday, January 24th 2014

1

Please review the documents attached

Scenario

Guide to Anticipated Consumer Issues

Topic

Guide to Anticipated Consumer Issues Jan2

Post Jan 1 2014 Customer Inquiries Memo

- 3 -

Agenda

Proper Documentation for Income

How to View Enrollment and Plan Details

Scanning and Uploading Verification Documents

Faxing Applications

Marriage Status for Estranged Spouses: APTC Implications

Enrolling in Husky

Not Lawfully Present Parents and their Citizen Children

Children’s Income on Application

APTC Result of $0

2/2 Release Notes

What documents are acceptable forms of income?

• The preferred document is an annual tax return

• To verify monthly income, the preferred income type is a full month’s worth of paystubs

o If a consumer is paid weekly – last 4 paystubs

o If a consumer is paid biweekly – last 2 paystubs

Is a written letter acceptable proof of no income?

• If a consumer has no income and does not file taxes, a self-attested letter is acceptable as proof of no income. Notarization is not necessary.

Scenario

Proper Documentation for Income

Topic

How do consumers view their enrollment details after they have enrolled in a

plan?

• Consumer will receive a notice in the mail containing their enrollment details.

• If a consumer has applied online, then the enrollment details are viewable on

the consumer’s Account Home page:

Scenario

How to View Your Enrollment Details

Topic

Step 2: • The consumer should enter their User ID and Password.

How to View Your Enrollment Details

Step 1: • The consumer should navigate to the Access Health CT

website and click Sign In.

Topic

Steps

6

How to View Your Enrollment Details

Step 3: • Consumers will immediately see their Enrollment Details

under My Plans on the consumer’s Account Home page.

Topic

Steps

7

How do consumers view their plan details after they have enrolled in a plan?

• Consumers are not able to access a detailed summary of their plan details

from their Account Home page.

• They must note the plan that they are enrolled in and view plan details through

the Anonymous Browsing feature on the Access Health CT homepage:

Scenario

How to View Plan Details

Topic

Step 2: • The consumer should enter the information to reflect their

household size and annual income, then click [Next].

How to View Your Plan Details

Step 1: • The consumer should navigate to the Access Health CT

website and click the Get Health Coverage tab.

Topic

Steps

9Note: The consumer should not be logged into their account.

Step 3: • The consumer should select [click here] on the Preliminary

Eligibility Results page.

Step 4: • The consumer should click [Details] to view their plan details.

How to View Your Plan DetailsTopic

Steps

10Note: The consumer should not be logged into their account.

• After consumers have submitted their application, they have the

opportunity to scan and upload their verification documents on the

Document Upload page.

• If a consumer decides not to upload their verification documents at that

point, the consumer will be able to upload their verification documents by

the following process:

Scenario

Scanning and Uploading Verification Documents

Topic

Step 2: • The consumer should enter their User ID and Password.

Scanning and Uploading Verification Documents

Step 1: • The consumer should navigate to the Access Health CT

website and click Sign In.

Topic

Steps

12

Step 4: • If the consumer still has verification documents to upload,

they should click Submit the document.

Scanning and Uploading Verification Documents

Step 3: • The consumer should click the My Inbox tab.

Topic

Steps

13

Scanning and Uploading Verification Documents

Step 5: • The consumer should fill out the required fields, upload the

document, and then click [Submit].

Topic

Steps

14Note: Verification documents should be combined into one document and File size should be limited to 2MB

• If a consumer has opted not to receive e-mail updates, they will receive a

paper notice and a cover letter from Access Health in the mail.

• The consumer should attach their verifications to this cover letter and

send their verifications to the mailing address listed on the notice.

• If a consumer has lost or misplaced their cover letter, they can call the Call

Center and it may be re-sent.

Scenario

Scanning and Uploading Verification Documents

Topic

Can a HUSKY application be faxed? If not, what is the procedure for

sending a paper application?

• The HUSKY enrollment center is not accepting fax applications

• Paper applications can be submitted in two ways:

o Mailed to the address provided on the paper application

o Delivered in-person at the local DSS office

The fastest way to submit an application is to forego the paper

application and apply online through Access Health CT

Scenario

Faxing applications

Topic

An individual is married with a child, however she and her husband have been separated for an extended period of time. She has little or no contact with the husband and does not know of his whereabouts. He doesn’t pay, or pays very little to support either her or the child (less than ½ of expenses for her household). She files her taxes as “Head of Household” or “Single.” Can she report that she is not married in order to be eligible for APTC?

An individual is NOT considered as married if the individual is married but files a separate return AND

o Has a son, stepson, daughter, or stepdaughter who lives with the individual for more than half the year AND can claim that child as a tax dependent

o Individual furnishes over half of the cost of maintaining such household during the taxable year; and

o During the entire taxable year such individual's spouse is not a member of such household.

Conclusion: If the individual meets the above criteria she can file as Single or “Head of Household” and should select “Not Married.”

Scenario

Marriage Status For Estranged Spouses: APTC Implications

Topic

Do consumers need to see DSS workers before completing an application to receive Husky?

There are 4 different categories of HUSKY (A, B, C & D):

• A consumer can enroll on the exchange for Husky A, B and D and does not have

to go to DSS before enrolling on the exchange.

• Individuals who qualify for Husky C, (also known as Medicaid for the

Aged/Blind/Disabled) & Medicaid for Employees with Disabilities, cannot enroll on

the exchange. Husky C eligible consumers should enroll through the DSS office.

Scenario

Enrolling in Husky

Topic

A family of 4 includes two parents who are not lawfully present (undocumented)

and complete taxes with a Tax ID number. The children in the household are US

citizens. Can the children apply on the exchange?

• There has been a fix to the system, therefore the steps to complete this application are

new.

• The household can still apply on the exchange. The parents will not be eligible to apply

for coverage since they do not have a valid SSN number, however the children will be

eligible.

• The oldest child no longer has to be the primary applicant.

• The parents will be entered into the system and one will be the primary applicant. Both

parents will select that they are “not requesting coverage” and will list their citizenship

status as unknown.

Scenario

Not Lawfully Present Parents and their Children

Topic

Father earns $60,000 and the only other income is a high school student who earns about $2,500 a year working part-time. The son did not file for taxes, e.g. under $10,000. Does the family have to enter total earnings as $63,000?

• No, the son’s income will not have to be reported since the amount is under

$10,000

• If the child had earned more than $10,000 over the course of the year, the

child will be required to include that income in the parents MAGI.

• The child is required to file if he/she makes more than $10,000. The child

could, if eligible, still be claimed as a tax dependent of a parent.

Scenario

Children’s Income on Application

Topic

Why would an individual who has income below 400% of the FPL receive an APTC eligibility result of $0.

• To determine APTC subsidies, the system first determines whether the consumer’s estimated annual income for next year falls below 400% FPL but above the financial limit required for Medicaid eligibility (assuming Medicaid eligible).

• The system will next calculate where on a floating scale between 2% and 9.5% of household MAGI the family will fall. Based on where they fall on that scale will dictate how much they will be required to contribute toward the cost of their coverage before any APTC they might be eligible for could kick in.

• The system compares the household’s estimated annual income against the premium for the second lowest cost silver plan to decide how much APTC the family is eligible for to close the gap between the cost of the plan and the amount they are required to contribute.

• If they choose a plan (almost always in the bronze category) which costs less than the amount of APTCs they are eligible for (since that is based on silver level) then the cost of the plan will be $0.

Scenario

APTC Result of $0

Topic

Scenario

2/2 Release Notes

Topic

2/2 Release Notes

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