Duplicate Marketplace Apps

Nov 10, 2015

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  1. ameneses54
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    ameneses54 Guru

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    A new doubt just popped into my mind and I need guidance.
    What happens if a customer has a Marketplace account in 2015 and you create a new one for 2016 through a web broker without cancelling the 2015?
    Logic would mandate that the 2015 would be renewed automatically and you end up with two accounts and policies in 2016. Does this make any sense?
     
  2. Sherota1
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    Sherota1 Super Genius

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    If you are doing this because you cannot find the old application using the Marketplace Access Tool call HC.gov. Give the CSR the application number if they tell you the application is not in the system. Tell them they need to do the search using only the application#. Some of the CSR's do not know this. If you are authorized on the account get all updates from your client and update the application over the phone until the eligibility letter is generated. End the call. Go back and lookup the 2016 application through the Marketplace Access Tool if you are using a WBE. It should come up. Finish the application and submission on your own to keep control of the transaction.
    If you are not authorized get authorization doing the usual 3 way call. Then follow the steps above

    If you do a new application without cancelling the old one especially if HC.gov already auto generated the new 2016 application for auto renewal they could possibly have two applications on January 1st. You will spend the next few months trying to fix the errors. Not worth it considering the fact that the insurance companies need permission from the Marketplace before they can cancel any plan which can take 30 days or more.
     
    Sherota1, Nov 10, 2015
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  3. saintstigers
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    saintstigers Guru

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    So I've noticed on my 2015 clients that had an exchange policy in-force...if I search up a 2016 application (via HealthSherpa access) the eligibility has already carried over and they've been approved with a subsidy (they didn't have to reapply)

    So is there a way using Health Sherpa to select a a plan for them using the already existing 2016 eligibility subidy that was auto-generated by HC.GOV? Without doing the entire application over again?
     
  4. Sherota1
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    Sherota1 Super Genius

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    Last year if the client did not want that plan or if their income changed you should be able to go in and terminate the plan and then pick another plan during OEP. Especially if their income changed or they want something else.
     
    Sherota1, Nov 10, 2015
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  5. saintstigers
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    Well it looks like for my 2015 exchange members that have had the 2016 eligibility automatically determined in Hc.gov. It shows the eligibility letter, but no 2016 plan is being shown as selected. One would think they'd have the 2016 version of their current policy already loaded for those exchange members that take no action?
     
  6. TN_agent
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    TN_agent Guru

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    Maybe they are waiting until December 15th at 11:59 pm to do that? Giving the people a chance to go in and actively reenroll or change coverage? The created 2016 renewal app is showing "ready to review" I think on hc.gov and their current plan is showing as a "suggested plan" or something like that. But will that change Dec. 15th?

    My headache right now is that if I go through a WBE without retrieving the renewal 2016 app number as described above, I fear the 2015 coverage will renew Dec. 15th or thereabouts as if they haven't taken action. But only because I didn't have the 2016 renewal app to retrieve and instead the WBE generated a new app.

    Is that the way everyone else understands it?
     
    TN_agent, Nov 10, 2015
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  7. saintstigers
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    saintstigers Guru

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    I was talking with a rep at hc.gov...they really have no clue on how it works
     
  8. Post Quartermaster
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    Rule #1-10.

    Dont call the FFM.
     
  9. Sherota1
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    Sherota1 Super Genius

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    There is not a policy already loaded in the new link. If the consumer does not take action before December 15th they will be automatically reenrolled under the new 2016 application ID. Creating a new application could cause dual enrollment issues. and a wasted spring and summer trying to fix issues.
    If they do not take action they will be reenrolled in their current plan if it is available based on their 2015 subsidy or the latest information that the IRS has. If their old plan is not available they will be auto enrolled in a similar plan which may be something they do not want or like.
    This is my concern as well. When the dust settles and I have all of my concerns addressed I will stick with the WBE I've used from the start especially for new enrollees. For renewals I'll use the companies direct enrollment platform which redirects to HC.gov so I can update the application directly from the HC.gov website. For applications that cannot be located through the Lookup Application tool I do the 3-way call up until the generation of the eligibility letter, close the call and pull the application and complete it myself. I'm also using a system through one of the agencies that I have a relationship with that also redirects to HC.gov. I'm almost 10 days behind but should have all of my renewals done by this week end or early next week for those that filed their 2014 taxes.
    I've been told more than once that creating a new application could cause problems. After dealing with a few people who did that last year I refuse to step into it this year. :cool:

    If anyone has heard something different let us know.
     
    Sherota1, Nov 12, 2015
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  10. saintstigers
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    So there no way to use Sherpa or any WBE to access a clients 2016 eligibility and enroll them into a different carrier than they're currently with?

    I wonder if you check a members app at hc.gov after Dec 15th if it will show 2 enrollment a...could you just terminate the incorrect one?
     
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