ACA 101: Post Enrollment - FAQ

Do consumers have a central location to upload documents and see their plan details that's easy to use?

• No, they have to mail documents for best results

• Yes, Healthcare.gov

• Yes! The consumer dashboard

• No, they have to access multiple sites to complete uploads

During special enrollment, can a consumer pay for their plan right away?

• Yes, they have to in order to have coverage

• Typically, no. They may have documents needing approval before they can pay

• No, they must wait at least one week for the insurance company to get their information

• They will get a bill in the mail

Can someone get their subsidy back if it's been removed? (select all that apply)

• If you lose it you have to wait until the next open enrollment

• Yes, but they must start by calling the marketplace

• Yes, but they may be required to pay the full price to keep their plan active

• Just reapply

If a consumer fails to submit documentation, what are the consequences?

• They can lose their subsidy or coverage

• The marketplace wont stop calling them

• Nothing

• The IRS will request they pay back all of their subsidy received

What documents are needed before payment can be made?

• Proof of citizenship

• Proof of income

• Evidence of birth

• Proof of qualifying life event

Answer explanation

Only during Special Enrollment Period are documents possibly required before payment can be made. Proving a qualifying life event before payment confirms eligibility.

How many days do consumers have to submit data matching issue documentation (Income, immigration, incarceration etc.)?

• 30 days

• 90 days

• 60 days

• 120 days

During Open Enrollment, when an application is complete, how long should a consumer wait to make payment?

• At least one week, this gives time for the marketplace to transmit their info to the insurance company

• They should not wait, pay asap

• At least two - three weeks, this gives time for the marketplace to transmit their info to the insurance company

• They will get a bill in the mail

Which email contains the link to create a password for their HealthSherpa account?

• Access Your Health Insurance Account

• Action Required: Next steps to finalize your coverage

• Follow ups requiring data matching documentation be submitted

• Continue Shopping

How many accounts might a consumer have in relation to their insurance / application?

• 1

• 2

• 3

• 4

Answer explanation

1. HealthSherpa - application management

2. Healthcare.gov - application management

3. Their Insurance Company - claims and benefit management

A consumer calls in with a complex situation, their plan was cancelled too late and they want it retroactively cancelled to the 1st of the month. What can we do?

• Get assistance to submit a ticket to the FFM Agent Broker help desk

• Send them to healthcare.gov

• Unfortunately, there is nothing that can be done on a plan that has been cancelled

• Log into their account and fix the date

Answer explanation

The folks working the help desk will call your direct line to confirm details, have the consumer info ready to verify, and they will almost always be able to solve the problem at which point you can follow up with the consumer to resolve. More details on this and an email template are in the knowledge base