WebEx Training
Friday, January 24th 2014
1
Topic
Guide to Anticipated Consumer Issues
Scenario
Please review the documents attached
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
-3-
Topic
Proper Documentation for Income
Scenario
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.
Topic
How to View Your Enrollment Details
Scenario
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:
Topic
How to View Your Enrollment Details
Steps
Step 1:
• The consumer should navigate to the Access Health CT
website and click Sign In.
Step 2:
• The consumer should enter their User ID and Password.
6
Topic
How to View Your Enrollment Details
Steps
Step 3:
• Consumers will immediately see their Enrollment Details
under My Plans on the consumer’s Account Home page.
7
Topic
How to View Plan Details
Scenario
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:
Topic
How to View Your Plan Details
Steps
Step 1:
• The consumer should navigate to the Access Health CT
website and click the Get Health Coverage tab.
Note: The consumer should not be logged into their
account.
Step 2:
• The consumer should enter the information to reflect their
household size and annual income, then click [Next].
9
Topic
How to View Your Plan Details
Steps
Step 3:
• The consumer should select [click here] on the Preliminary
Eligibility Results page.
Note: The consumer should not be logged into their
account.
Step 4:
• The consumer should click [Details] to view their plan details.
10
Topic
Scanning and Uploading Verification Documents
Scenario
•
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:
Topic
Scanning and Uploading Verification Documents
Steps
Step 1:
• The consumer should navigate to the Access Health CT
website and click Sign In.
Step 2:
• The consumer should enter their User ID and Password.
12
Topic
Scanning and Uploading Verification Documents
Steps
Step 3:
• The consumer should click the My Inbox tab.
Step 4:
• If the consumer still has verification documents to upload,
they should click Submit the document.
13
Topic
Scanning and Uploading Verification Documents
Steps
Step 5:
• The consumer should fill out the required fields, upload the
document, and then click [Submit].
Note: Verification documents should be combined into
one document and File size should be limited to 2MB
14
Topic
Scanning and Uploading Verification Documents
Scenario
•
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.
Topic
Faxing applications
Scenario
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
Topic
Marriage Status For Estranged Spouses: APTC Implications
Scenario
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
o
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
Individual furnishes over half of the cost of maintaining such household during the taxable
year; and
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.”
Topic
Enrolling in Husky
Scenario
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.
Topic
Not Lawfully Present Parents and their Children
Scenario
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.
Topic
Children’s Income on Application
Scenario
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.
Topic
APTC Result of $0
Scenario
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.
Topic
2/2 Release Notes
Scenario
•
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