Consent Forms Need To Go Away.....

[Jim Wright]

OK, anytime you assist your insured with a plan change, you need a new consent form for HS. Healthcare.gov does NOT require a new consent form

No, healthcare.gov requires it. HS only follows their rules. And it's not just for plan change. If you go on their application and change their income by $1, you are required to do a consent form. If you update a birthday or add a SSN for a new baby, consent form.

 

[InsuranceGuy29]

No, healthcare.gov requires it. HS only follows their rules. And it's not just for plan change. If you go on their application and change their income by $1, you are required to do a consent form. If you update a birthday or add a SSN for a new baby, consent form.

Literal insanity. Talk about throwing a roadblock up for agents to properly do their jobs. Thank God CMS is getting completely cleaned out soon. To the morons that are currently in there....no agent is benefitting by updating a client's info. There is no fraud there at all, bozos.

 

[Jim Wright]

Literal insanity. Talk about throwing a roadblock up for agents to properly do their jobs. Thank God CMS is getting completely cleaned out soon. To the morons that are currently in there....no agent is benefitting by updating a client's info. There is no fraud there at all, bozos.

That's not true at all. Besides the AOR fraud that happens in OE, there is an SEP available all year to people under the 150% FPL. Call centers could change someone's income to that level, change their plan to a $0/mth plan and they won't notice. MP also stopped asking for proof of loss of coverage so they could go in and click that box as well for a mid year plan shift.

It was harder last year because a few carriers did AOR lock but not all did

 

[Yagents]

Hello. Read the rules. You only need new consent form if original one had an expiration date or was revoked.

Each time you update app, you DO need new an eligibility verification from the customer

 

[renee15]

No, healthcare.gov requires it. HS only follows their rules. And it's not just for plan change. If you go on their application and change their income by $1, you are required to do a consent form. If you update a birthday or add a SSN for a new baby, consent form.

I printed this off their website-
"CMS does not specify an automatic expiration date of the consent because it could become burdensome for anyone consistently seeking services from the same agent/broker to have to repeatedly renew the consent. Therefore, the consent may last indefinitely, unless the individual revokes it. Consent documents must be appropriately secured and retained for 10 years."

 

[Jim Wright]

I printed this off their website-
"CMS does not specify an automatic expiration date of the consent because it could become burdensome for anyone consistently seeking services from the same agent/broker to have to repeatedly renew the consent. Therefore, the consent may last indefinitely, unless the individual revokes it. Consent documents must be appropriately secured and retained for 10 years."

Also from CMS:
However, any time an agent, broker, or web-broker takes an action to update a consumer's eligibility application or plan selection, and the existing documentation of consumer consent does not authorize the agent broker to take those actions, they must obtain and document consumer consent to those actions and maintain that consent documentation. Agents, brokers, and web brokers must never change a consumer's eligibility application information or plan selection without documenting that the consumer consented to the change. Further, agents, brokers, and web-brokers must also always document that the consumer reviewed and confirmed the accuracy of the eligibility application information prior to the agent or broker submitting the eligibility2application to the Marketplace, including updates or changes to an existing Marketplace application.

If you are using the HealthSherpa consent, it doesn't specifically cover changes to apps and I would assume most people are using the standard guidelines from CMS that do not have those things listed.

All the answers are on page 2.

https://www.cms.gov/files/document/frequently-asked-questions-consumer-consent-application-review-requirements.pdf

 

[renee15]

Also from CMS:
However, any time an agent, broker, or web-broker takes an action to update a consumer's eligibility application or plan selection, and the existing documentation of consumer consent does not authorize the agent broker to take those actions, they must obtain and document consumer consent to those actions and maintain that consent documentation. Agents, brokers, and web brokers must never change a consumer's eligibility application information or plan selection without documenting that the consumer consented to the change. Further, agents, brokers, and web-brokers must also always document that the consumer reviewed and confirmed the accuracy of the eligibility application information prior to the agent or broker submitting the eligibility2application to the Marketplace, including updates or changes to an existing Marketplace application.

If you are using the HealthSherpa consent, it doesn't specifically cover changes to apps and I would assume most people are using the standard guidelines from CMS that do not have those things listed.

All the answers are on page 2.

https://www.cms.gov/files/document/frequently-asked-questions-consumer-consent-application-review-requirements.pdf

My existing consent form allows for me to pull their app and make changes until they revoke consent. I have them on the phone while we are looking at changes and they provide consent again (recorded call)

 

[HealthGuy]

ACA client consent ONCE until revoked (if ever)...What is the rub here I don't get the arguments against ONE and DONE CONSENT.

 

[renee15]

Also from CMS:
However, any time an agent, broker, or web-broker takes an action to update a consumer's eligibility application or plan selection, and the existing documentation of consumer consent does not authorize the agent broker to take those actions, they must obtain and document consumer consent to those actions and maintain that consent documentation. Agents, brokers, and web brokers must never change a consumer's eligibility application information or plan selection without documenting that the consumer consented to the change. Further, agents, brokers, and web-brokers must also always document that the consumer reviewed and confirmed the accuracy of the eligibility application information prior to the agent or broker submitting the eligibility2application to the Marketplace, including updates or changes to an existing Marketplace application.

If you are using the HealthSherpa consent, it doesn't specifically cover changes to apps and I would assume most people are using the standard guidelines from CMS that do not have those things listed.

All the answers are on page 2.

https://www.cms.gov/files/document/frequently-asked-questions-consumer-consent-application-review-requirements.pdf

As I said-I typed up my own form using their example for a guideline.

"There may be situations where the initial consent you collect from the consumer provides consent for subsequent actions such that you may not need to generate a new consent form for each action. For example, agents, brokers, and web-brokers may establish an agreement with their consumers (or their authorized representatives) at the time of initial Marketplace enrollment that allows them to check the status of eligibility applications throughout the year to help resolve data matching issues. In such situations, as long as this consent has not been rescinded or expired, an agent, broker, or web-broker may rely on this consent"

Except as I said before-Health Sherpa EDE requires annual consent even though healthcare.gov does not

 

[HealthGuy]

Health Sherpa EDE does NOT require annual consent.