AUTO DIALER INBOUND CALLS AND THE
PDF APPLICATION TRAINING ALERT (UPDATED)
Effective Date
June 5, 2014 (This version replaces version 5.0 from March 4, 2014)
Audience
Marketplace Customer Service Representatives (CSRs)
Related Reference Material
The following scripts are related to this training:
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Authorizations and Disclosure
Consumer Application Status
Enrollment Cancelation, Disenrollment, or Reapplying for a Marketplace Plan
Getting Coverage Outside Open Enrollment
HICS Escalation Lead-In
HICS Escalation – Special Enrollment Periods
Reporting a Life Change and Special Enrollment Periods
Plan Compare and Enrollment Closing Language
Welcome Consumers and Direct Calls
The following training materials are related to this training:
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Recording Changes in Circumstance Training Alert
Removing Plan Enrollments and Applications Training Alert
Terminating Coverage Training Alert
Assisting Applicants with Plan Comparison Reference Material
Assisting with the Online Application Reference Material
Disclosure Desk Reference Training for Marketplace
Marketplace Call Flow Reference Material
Recording Changes in Circumstance Reference Material
What’s Changed?
If you reviewed this training alert prior to March 4, 2014, please note the following:
•
The Changes to Application section of this training alert has been updated to list the steps for helping consumers make
the following changes to their applications:
 Restarting the application process
 Canceling an enrollment or terminating coverage
 Updating contact information or reporting a life change
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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The information in this training alert can also be found in the Marketplace Call Flow Reference Material available in the
Next Generation Desktop (NGD).
Introduction
When consumers’ applications are entered into the HealthCare.gov online application system, the consumers are contacted
about the status of their applications by an auto dialer. The auto dialer is a computer program that calls consumers’ telephone
numbers and leaves recorded messages about the status of their applications. These recorded messages communicate
information regarding consumers’ PDF and online applications, eligibility results, and technical issues. These messages are
intended to prompt consumers to call the Marketplace so they may complete the application, eligibility, comparison, and
enrollment (AECE) process. When these consumers call the Marketplace, there will be a call indicator in NGD alerting CSRs as to
what messages the consumers received.
Auto Dialer Messages
Currently, there are 8 auto dialer messages used to communicate the status of consumers’ applications:
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Auto Dialer Message 1 – PDF Complete: Indicates that a consumer’s application has been entered, contains no errors,
and has generated eligibility results. The message prompts the consumer to call back and enroll in a plan.
Auto Dialer Message 2 – PDF Blank: Indicates that a consumer’s PDF application is blank and no information has been
captured. The message prompts the consumer to call back and complete an application.
Auto Dialer Message 3 – PDF Missing Information: Indicates that a consumer’s application contains gaps or is missing
information. The message prompts the consumer to call back and provide additional information to complete the
application.
Auto Dialer Message 4 – Changes to Application: Indicates the consumer called the Marketplace to change their
application. The message requests a return call to make the required updates to the application.
Auto Dialer Message 5 – Eligibility Issues Callbacks: Indicates that the CSR entering the PDF application experienced a
system error. The message prompts the consumer to call back to continue the application process and provide
additional information as needed to complete the application.
Auto Dialer Message 6 – ARC Technical Issues: Indicates the consumer’s application couldn’t be completed due to
technical issues, and their issue was previously escalated to the ARC. The message prompts the consumer to call back
to complete their application because the technical issues have been resolved.
Auto Dialer Message 7 – New Consumer: Indicates the consumer completed an application, but hasn’t finished the
enrollment process. The message prompts a consumer who’s finished an application and received eligibility results, to
call back or go to HealthCare.gov and submit their enrollment, if they haven’t already done so.
 Consumers who receive the New Consumer message may not have contacted the Marketplace before, and
may not have a Contacts records in NGD. Even though these consumers may not have contacted the
Marketplace before, these messages are official communications from the Marketplace and are not fraud.
Auto Dialer Message 8 – Reporting a Life Change and Special Enrollment Periods: Indicates the consumer called the
Marketplace to update a submitted application due to a change in their life or household. The message prompts the
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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consumer to call back and make the required updates to their application or make changes to their application at
HealthCare.gov by logging into their account and selecting the Report a Life Change button.
Receiving an Inbound Call Prompted by an Auto Dialer Message
When a consumer calls the Marketplace after receiving a message from the auto dialer, the call goes through the interactive
voice response (IVR), as usual, and is either routed directly to a CSR or placed in queue.
When you receive the call, a computer telephony integration (CTI) pop appears on the FFM Contacts screen (refer to Figure 1),
indicating the consumer may have previous Call record with an application on file.
Figure 1: FFM Contacts Screen
Viewing a Call Indicator and Locating Online Application Details
Use the Marketplace Call Flow Reference Material and the AECE process to help you work though the call. Read and log the
Welcome Consumers and Direct Calls script and determine the consumer’s state of residency, then follow these steps:
Step 1.
On the FFM Contacts screen, verify that the consumer’s Contacts record autopopulated and is accurate.
Step 2.
Select the Applications view and ask the consumer to pass disclosure using the FFM Consumer Disclosure form
applet.
For consumers to pass disclosure, they must now provide their full name, address, and 2 additional pieces of information from
the following: Social Security number (SSN), application ID, FFM user ID, date of birth, and phone number.
Refer to the Marketplace Call Flow Reference Material, Disclosure Desk Reference (DDR) and the Authorizations and
Disclosure script for guidance on asking consumers to pass disclosure.
Step 3. Review the Call Indicator field on the FFM Contacts screen. An M-Consumer Message(s) call indicator displays in
the Call Indicator field to indicate the consumer received a message from the Marketplace (refer to Figure 2).
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Figure 2: Call Indicator Field
Step 4.
Select the Messages view on the FFM Contacts screen (refer to Figure 3) to access the Consumer Message list
applet.
Figure 3: Messages View
Step 5.
In the Consumer Message list applet, review the message type displaying in the Message Type column (refer to
Figure 4).
The message types that appear in this column are: PDF Complete, PDF Blank, PDF Missing Information, PDF Changes to
Application, PDF Eligibility Issues Callbacks, ARC Technical Issues, and New Consumer.
The Consumer Message list applet does not display a message for the Reporting a Life Change and Special Enrollment
Periods auto dialer messages. Skip to Step 10 to navigate back to the Applications view, locate the consumer’s
application, and continue the call.
Figure 4: Consumer Messages List Applet
Step 6.
Scroll to the Message Details form applet (refer to Figure 5), which contains the following fields:
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Message Type General Information: Displays the message you will read to the consumer to explain why
they were contacted by the Marketplace and to communicate your next steps to help the consumer move
through the AECE process.
Code Description: Displays a Spanish version of the script shown in the Message Type General
Information field.
CSR Notes Description: Displays notes explaining how you are to proceed with the call.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Figure 5: Message Details Form Applet
Step 7.
When you review the information in the Message Details form applet:
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Read the information in the CSR Notes Description field to yourself to identify your next steps.
Read the information in the Message Type General Information field to the consumer to tell them how
you will proceed.
The Message Details form applet is dynamic. The messages and notes that appear are tailored to each consumer
according to where they are in the AECE process.
Step 8.
In the Consumer Message list applet, select the blank Message Read field (refer to Figure 6) to place a check
mark in the field. The check mark indicates the consumer called back to address the auto dialer message.
Figure 6: Message Read Field
It is important that you complete this step to mark the message as read. If you do not, the assumption is that the
consumer has not called back to address the auto dialer message.
Step 9. Select the Log Sub-Activity button on the Messages view of the FFM Contacts screen.
Step 10. Navigate back to the Activities view (refer to Figure 7) and verify that the consumer’s SSN is populated in the
Contacts list applet.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Figure 7: Applications View
Step 11. From the Consumer Demographics form applet, select the Link Record button if it is available. If record is
already linked, the Link Record button is disabled.
Step 12. Scroll to the Application list applet and select the appropriate Application ID link from the Application ID column
(refer to Figure 8). The FFM Individual Application Detail screen will appear (refer to Figure 9).
Figure 8: Sample Application ID
Figure 9: FFM Individual Application Detail Screen
Step 13. Continue with the call according to the auto dialer message the consumer received. Select the link to read the
steps associated with each message.
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PDF Complete
PDF Blank
PDF Missing Information
PDF Changes to Application
PDF Eligibility Issues Callbacks
ARC Technical Issues
New Consumer
Reporting a Life Change and Special Enrollment Periods
Step 14. Set the Status field to Done in the Activities list applet on the FFM Contacts screen when the consumer has
moved as far as possible in the AECE process and you’ve completed the call.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Responding to Consumer Messages
The next sections of this training alert discuss the specific steps to take for each of the consumer messages to help the
consumer move through the AECE process at HealthCare.gov. Select the links in each section to navigate between the sections
of this document.
PDF Complete
When the Consumer Message list applet displays a PDF Complete message, and you have completed the steps outlined on
pages 3 – 6, follow these steps to continue the call. They will help you launch the online tool and assist the consumer compare
plans.
Step 1.
From the FFM Individual Application Detail screen, confirm the consumer has received an eligibility result by
checking the Applicant Eligibility list applet.
Step 2.
Select the Update Application button. The HealthCare.gov website opens in a new window. You may need to
sign in first.
Step 3.
Select the 2014 Application for Individual and Family Coverage link. The View Eligibility Results screen appears.
Step 4.
Scroll to the bottom of the View Eligibility Results screen and select the Next button. The Enroll To-Do List
screen appears.
Step 5.
Follow the instruction in the Enroll To-Do List screen to assist the consumer with the following:
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Step 6.
Choosing the tax credit amount (if the consumer is eligible for a tax credit) to be used toward monthly
premiums
• Setting insurance preferences, such as tobacco usage, need for dental coverage, and groups of household
members who will share a Marketplace plan
• Choosing the plan or plan that best suit the consumer’s needs
Help the consumer compare plans.
Carefully read the information on each screen to the consumer. The consumer cannot see the page and relies on you to
relay the information.
Step 7. Make updates to the Contacts record, if necessary, and review the consumer’s application details. Refer to the
Assisting Applicants with Plan Comparison Reference Material for additional information. You can access this
document from the FFM Reference Materials screen in NGD.
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PDF Blank
When the Consumer Message list applet displays a PDF Blank message and you have completed the steps outlined on pages 3
– 6 (you may skip the Link Record steps), follow these steps to continue the call. They will help you launch the online tool and
assist the consumer with completing a new online application at HealthCare.gov.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Do not tell the consumer that the PDF application is blank.
Step 8. Navigate to the Applications view.
Step 9.
Select the Create New Application button on the Applications view.
The HealthCare.gov website opens in a new window. Refer to the Assisting with the Online Application Reference
Material for additional information. This document is accessible from the FFM Reference Materials screen in
NGD.
Step 10. Use your soft skills to encourage the consumer to provide their SSN. A consumer’s SSN is not required when
starting an application; however, you should encourage the consumer to provide it.
Step 11. Verify the consumer’s identity. To verify a consumer’s identity from NGD, follow these steps:
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Select the Get Started button on the ID Proofing screen.
Ask the consumer to provide the information shown on the Contact Information screen. Complete the
entries on this screen as the consumer directs.
• Select the Continue button.
• Read each identity question to the consumer. Select the answer the consumer chooses.
• Select the Continue button.
Step 12. After you complete ID proofing (successfully or unsuccessfully), proceed with the 5 sections for the application:
Get Started, Family & Household, Income, Additional Information, and Review & Sign.
Step 13. When you reach the Review & sign screen, do the following:
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Review and confirm all information.
Complete Agree / Disagree statements.
Submit the application.
Do not select the SUBMIT APPLICATION button more than once. Selecting this button repeatedly resubmits the
application and may cause delays or technical issues.
Step 14. Help the consumer compare plans.
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PDF Missing Information
When the Consumer Message list applet displays a PDF Missing Information message, and you have completed the steps
outlined on pages 3 – 6 (you may skip the Link Record steps), follow these steps to continue the call. They will help you launch
the online tool, verify whether an online application has been started, and complete an existing online application or start a
new application as appropriate.
Step 1.
Select the Applications view and do one of the following:
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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•
Step 2.
Create a new online application if one has not already been started by selecting the Create New Application
button on the Applications view.
• Continue with an existing online application by following these steps:
Select the Application ID link.
Step 3.
Select the Update Application button on the FFM Individual Application Details screen.
Step 4.
Read everything on the application to the consumer as you are completing the application, especially the
attestations in Step 5: Read & sign this application.
Step 5.
Select the Agree radio button to sign the application.
Step 6.
Select the Submit Application button to submit the application.
After you select the Submit Application button, the system may lock, and then display the Submit Application button
again as if the submission did not go through. If this occurs, log out of HealthCare.gov, return to NGD, and select the
Update Application button to relaunch HealthCare.gov.
Step 7. Continue to assist the consumer with eligibility results using the appropriate scripts.
Step 8.
If appropriate, help the consumer compare plans and enroll.
Step 9.
After you help the consumer compare plans, read the Plan Compare and Enrollment Closing Language script, and
return to the Activities view on the FFM Contact screen.
Be sure to select the Submit button only once. Selecting more than once resubmits the entire application and may
cause additional delays.
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Changes to Application
When the Consumer Message list applet displays a Changes to Application message, and you have completed the steps
outlined on pages 3 – 6, refer to the scripts and steps below to continue the call. They will help you make the following changes
to the consumer’s application: restart the application process; cancel an enrollment or terminate coverage; or update the
consumer’s contact information or report a life change.
Restarting the Application Process
If the consumer is not enrolled in a plan and wants to restart the application process, you may help the consumer remove an
in-progress or completed application and begin the application and enrollment process again. Refer to the Removing an
Application or Canceling Plan Enrollment script and follow these steps:
Reviewer Note: We are tracking changes to the Helping Consumers Make Changes Reference Material to determine if the
steps for removing applications should be removed from this section.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Step 1.
On the FFM Individual Application Detail screen, review the consumer’s enrollment status in the Enrollment list
applet to determine if the consumer is enrolled in a plan.
Step 2.
Select the Update Application button.
Step 3.
Log in to HealthCare.gov using your NGD credentials.
Step 4.
In the View my current applications section of the main page, select the REMOVE button for the application you
want to remove.
Step 5.
The Reset my application pop-up box appears. Read the full text of the pop-up screen to the consumer.
Step 6.
Confirm with the consumer that they want to remove the application.
Step 7.
Select the RESET button to remove the application, or select the CANCEL button if the consumer does not wish
to proceed.
Step 8.
Confirm the application was successfully removed, and select the CLOSE button. After you select CLOSE, an error
screen may appear. To resolve the error, proceed to the next step.
Step 9.
Log out of your Marketplace account, clear your browser’s cache, and close your browser.
Step 10. In NGD, verify that the application no longer appears. Then, start a new application on behalf of the consumer.
You must remove the consumer’s in-progress or completed application before you start the new application. Refer to
the Removing Plan Enrollments and Applications Training Alert and Marketplace Call Flow Reference Material for
additional guidance.
Cancelling Enrollment/Terminating Coverage
If the consumer is enrolled in a plan and wants to cancel their enrollment before the effective date or disenroll from their plan
by terminating coverage after the effective date, refer to the Enrollment Cancelation, Disenrollment, or Reapplying for a
Marketplace Plan script and tell the consumer:
•
They cannot enroll in a new plan until the next open enrollment period (OEP), which will run from November 15, 2014,
through February 15, 2015, unless they qualify for a special enrollment period (SEP).
• They are terminating coverage for everyone listed on that plan. Other people on the plan, besides the applicant, may
qualify for SEPs to enroll in new coverage.
• They are terminating coverage for their Marketplace health and dental plans. At this time, a consumer cannot cancel
one plan independent of the other.
• If the consumer or their dependents don’t have coverage, they may have to pay the fee for not having coverage unless
they qualify for an exemptionBefore you help a consumer cancel their plan or terminate coverage, see if they may have
another option and make sure they understand the consequences of terminating coverage.
If the consumer still wants to cancel their enrollment or terminate coverage, refer to the Enrollment Cancelation,
Disenrollment, or Reapplying for a Marketplace Plan script and follow these steps:
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Step 1.
On the FFM Individual Application Detail screen, review the consumer’s enrollment status in the Enrollment list
applet to confirm they are enrolled in a health and / or dental plan.
Step 2.
Select the Update Application button. The CCR Marketplace Application Access screen appears.
Step 3.
Log in using your NGD credentials. The consumer’s Marketplace account appears.
Step 4.
Select the My plans & programs link. The consumer must select a termination date that is at least 14 days from
the present date.
Step 5.
Confirm with the consumer that they want to terminate coverage.
Step 6.
Scroll down to the Plan Details section of the screen.
Step 7.
Select the TERMINATE COVERAGE button. The Status: Cancelled banner appears.
Refer to the Terminating Coverage Training Alert and Marketplace Call Flow Reference Material for additional
guidance.
Updating Contact Information or Reporting a Life Change
If the consumer is enrolled in a plan and wants to update their contact information or report a life change, refer to the
Reporting a Life Change and Special Enrollment Periods script and follow these steps:
Step 1. Select the FFM Individual Application Detail screen.
Step 2. Select the Update Application button.
Step 3. From the MY APPLICATIONS & COVERAGE screen, select the desired application link under the View my current
applications link.
Step 4. Select the REPORT A LIFE CHANGE button. The Report a life change pop-up screen appears.
Step 5. Follow the instructions on the Report a life change pop-up screen to record the desired change and update the
consumer’s application.
Do not use the Report a Life Change link to adjust advance premium tax credit (APTC) amounts for consumers who do
not have a change in circumstance (CIC). These consumers must wait for the next OEP or qualify for an SEP to update
their APTC amount.
If the consumer is updating their application to report a CIC that may affect their eligibility, HealthCare.gov will ask additional
application questions to determine SEP eligibility.
After reporting a CIC, the consumer’s new eligibility results indicate whether they are eligible for an SEP, a different APTC
amount, or both. If the consumer is eligible for an SEP, they can compare plans and enroll in a new plan.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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If a consumer is not enrolled in coverage and does not qualify for an SEP based on their CIC, it is important to check whether
they qualify for another kind of SEP. Use the Getting Coverage Outside of Open Enrollment script to encourage the consumer to
complete an application to see if the consumer qualifies for another kind of an SEP.
You may have a consumer who insists they should get an SEP, even though their eligibility results read differently and
scripting does not indicate that they should get an SEP. If this happens, use the HICS Escalation Lead-In script to
complete a Health Insurance Casework System (HICS) escalation to request Regional Office (RO) approval of an SEP for
the consumer.
If a consumer is eligible for an SEP because of a CIC, they can switch plans if they have an existing enrollment, or enroll in a
new plan if they have never enrolled.
If the consumer is eligible for an SEP and decides to enroll in a new plan, the start date will depend on the SEP type and the
date the consumer selects the new plan (refer to Table 1).
If a consumer is eligible for an SEP, already enrolled in a plan, and switching to another plan, the termination date of
their current plan is the day before the effective date of their new plan. For example, if the effective date of a
consumer’s plan is June 1, the termination date of their current plan is May 31. The consumer’s current plan will
terminate automatically the day before the effective date of their new plan.
Table 1: Plan Start Dates Based on an SEP
Type of SEP
Eligible for an SEP based on one of the following CICs:
• Moving to a new health plan service area
• Being released from incarceration
• Becoming lawfully present
• Status as an American Indian / Alaska
Native
Loss of other coverage that qualifies as minimum
essential coverage (MEC) or gaining a dependent
through marriage
Future loss of other coverage that qualifies as MEC (loss
up to 60 days in the future)
Birth, adoption, or placement for adoption or foster care
New Plan Selection Date
Between the first and
fifteenth day of the month
New Plan Start Date
First day of the following month
Between the sixteenth and
last day of the month
First day of the second following
month
Any day of the month
First day of the following month
Any day of the month
First day of the month following the
date of the loss of an MEC
Day the child was born, adopted, or
placed for adoption or foster care
Any day of the month
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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The Marketplace will inform the consumer’s health insurance company that the consumer enrolled in a Marketplace
plan. Advise the consumer to contact the health insurance company with questions about premium payment dates
and for additional information.
Refer to the Recording Changes in Circumstance Training Alert, Recording Changes in Circumstance Reference Material,
and Marketplace Call Flow Reference Material for additional guidance.
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PDF Eligibility Issues Callbacks
When the Consumer Message list applet displays a PDF Eligibility Issues Callbacks message, and you have completed the steps
outlined on pages 3 – 6, follow these steps to continue the call. They will help you assist the consumer with completing an
online application.
Step 1.
Select the Applications view.
Step 2.
Review the CSR Comments field on the Attachments view of the FFM Activities screen to determine where the
previous CSR left off in the consumer’s application.
Step 3.
Follow the steps in the PDF Missing Information section to complete the consumer’s application and help them
compare plans.
Step 4.
If you encounter technical issues preventing you from continuing the application:
•
•
Enter detailed notes in the CSR Comments field on the Activities view of the FFM Contacts screen regarding
where you left off in the online application.
Continue with the AECE process, if possible.
If the consumer’s application is complete and was submitted as a PDF, they may have to wait longer for an eligibility
results.
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ARC Technical Issues
When the Consumer Message list applet displays an ARC Technical Issues message, and you have completed the steps outlined
on pages 3 – 6, follow these steps to continue the call. They will help you launch the online tool and assist the consumer with
completing the application and enrollment process. If the consumer is upset about providing their application information again,
use your soft skills to calm the consumer.
Step 1.
Locate the consumer’s online application on the FFM Individual Application Detail screen.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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Step 2.
Select the Update Application button. The HealthCare.gov website opens in a new window. You may need to
sign in first.
Step 3.
Follow the steps in the Changes to Application section to resume an application or to remove an existing
application and begin the application and enrollment process again.
•
•
If you are able to resume the consumer’s existing application, refer to the Consumer Application Status
script.
If you must remove the consumer’s existing application and begin application and enrollment process
again, refer to the Enrollment Cancellation, Disenrollment, or Reapplying for a Marketplace Plan script.
If you encounter technical issues preventing the consumer from enrolling, refer to the Technical Issues script and offer to
help the consumer walk back through the application and add an SEP (for the date of the call). If you experience
continued technical issues, use the blocker / locked to do-list process to transfer the consumer to ARC. Do not escalate
the issue to the RO.
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New Consumer
When the Consumer Message list applet displays a New Consumer message, and you have completed the steps outlined on
pages 3 – 6, follow these steps to continue the call. They will help you assist the consumer with completing the enrollment
process.
Step 1.
From the FFM Individual Application Detail screen, confirm the consumer has received an eligibility
determination by checking the Applicant Eligibility list applet.
Step 2.
Select the Update Application button. The HealthCare.gov website opens in a new window. You may need to
sign in first.
Step 3.
Follow the steps in the PDF Complete section to help the consumer compare plans and enroll in health coverage.
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Reporting a Life Change and Special Enrollment Periods
When the consumer indicates they need to update a submitted application due to a change in their life or household, and you
have completed the steps outlined on pages 3 and 4, follow these steps to continue the call. They will help you launch the
online tool and assist the consumer with updating an existing application.
The Consumer Message list applet does not display a message for Reporting a Life Change and Special Enrollment
Periods auto dialer messages.
To help a consumer update an application due to a change to their life or their household, follow the steps to update contact
information or report a life change in the Changes to Application section of this document.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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AUTO DIALER INBOUND CALLS AND THE
PDF APPLICATION TRAINING ALERT (UPDATED)
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Online Tool Not Available
In the event the online application tool is down and a consumer’s application is not available, do the following:
Step 1.
Use the applicable scripting according to the message the consumer received and where they are in the AECE
process.
Step 2.
Enter detailed notes in the CSR Comments field describing where you left off in the consumer’s application.
More Information
Please contact your supervisor or the Internal Support Group (ISG) if you have questions.
Next Steps
To complete this training and receive credit, close the training by selecting the Exit button in the top-right corner of the
document. Select the Return to Content Structure button in Contact Center Operations (CCO) Learning, and then select the
survey hyperlink associated with the training. On the first page of the survey, acknowledge that you have read and understand
the Message from Instructor by placing a check mark in the box next to “I have read the Message.” Then, select the Start
Survey button to complete the survey.
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may
be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not
authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
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