- 4,716
I have another question.
Are any of you Bozos writing any UHC apps this OEP??
Are any of you Bozos writing any UHC apps this OEP??
Health Sherpa 2016 Open Enrollment
- Thread starter ameneses54
- Start date
- 8,448
WHY? Are the UHC quotes in Health Sherpa incorrect? I'm finally seeing Illinois HealthSherpa quotes match up with healthcare.gov.
- 4,716
You'll know why very soon...........stay tuned for news about UHC.
**Question here**
I may be wrong, but please correct me if so. It was always my understanding that if one has access to health insurance through a spouse's employer (regardless of the cost of the spouse), then they are not eligible for APTC? Is that right?
I had a gentlemen call me. He's currently on-exchange with BCBS of TX. Last year he applied directly with 1-800-healthcare. This year he's looking for some local advice.
So as I'm asking the questions, I ask if his wife is applying. He said no. I asked about her current insurance, "Oh she gets it through her job. But it's way too expensive to add me on there." So, this confused me. Shouldn't have the marketplace caught that when applying? He said no one ever asked him about that, only if his employer offered coverage, which they didn't.
So now, I go back and look through the Health Sherpa enrollment, and it doesn't ask either. You just go to the person applying for coverage, and the only question in reference to employers insurance is, "Does this person's employer offer health insurance?"
Not, "Does this person have access to employer sponsored health insurance either personally or through a spouse?"
Then you go to the "add other person" who is not applying for coverage, and there is no question about their insurance.
So, it looks like someone could 100% honestly sign up for health care on-exchange and get subsidies, while still having the opportunity to get health insurance through a spouses' employer. Someone enrolling themselves on healthsherpa would have no way of knowing the ACA rules about a spouse's job-offered coverage and the affordability rule.
What am I missing?
I may be wrong, but please correct me if so. It was always my understanding that if one has access to health insurance through a spouse's employer (regardless of the cost of the spouse), then they are not eligible for APTC? Is that right?
I had a gentlemen call me. He's currently on-exchange with BCBS of TX. Last year he applied directly with 1-800-healthcare. This year he's looking for some local advice.
So as I'm asking the questions, I ask if his wife is applying. He said no. I asked about her current insurance, "Oh she gets it through her job. But it's way too expensive to add me on there." So, this confused me. Shouldn't have the marketplace caught that when applying? He said no one ever asked him about that, only if his employer offered coverage, which they didn't.
So now, I go back and look through the Health Sherpa enrollment, and it doesn't ask either. You just go to the person applying for coverage, and the only question in reference to employers insurance is, "Does this person's employer offer health insurance?"
Not, "Does this person have access to employer sponsored health insurance either personally or through a spouse?"
Then you go to the "add other person" who is not applying for coverage, and there is no question about their insurance.
So, it looks like someone could 100% honestly sign up for health care on-exchange and get subsidies, while still having the opportunity to get health insurance through a spouses' employer. Someone enrolling themselves on healthsherpa would have no way of knowing the ACA rules about a spouse's job-offered coverage and the affordability rule.
What am I missing?
Last edited:
- 8,448
That's an excellent observation TwoLabs. Health Sherpa support is back to reading the forum again, and will hopefully address your findings.
Had a lead call yesterday said same thing. I asked her the questions and she said that Healthcare.gov asked her if she had insurance through a spouse or her job. she said no. she didn't have insurance she didn't tell them she could not afford it. she got $600 a month in tax credits. I told her she should probably call healthcare.gov and have them redo the application and good luck with the IRS next year. yikes
Hello all,
We apologize for the delay in posting. We were caught off guard by yet another unprecedented wave of demand - we've received and submitted in excess of 40,000 policies from 3,000 FFM certified agents during the first week. We are watching this thread very closely, and will be deploying enhancements and fixes throughout the upcoming weeks.
I did want to give some quick updates on what we've released in the last few days:
1) Overhauled data to match HC.gov on benefits. We also audited availability on a per zip/county level and added/removed several carriers.
2) Updated plan detail displays to match your preferences when you are logged in.
3) Updated quoter for accuracy (3 dependent under 21 cap, etc.)
4) Added a Save and Resume feature throughout the entire process. Saved quotes / enrollments go into your leads page, and can be resumed from there.
Besides general fixes / reliability improvements, we have several enhancements coming out soon to improve the quoting, shopping and renewal process. if you have an app specific inquiry you can reach out to us at [email protected]. For general issues, please continue to post on the forum, so that we can update everyone at the same time - my colleagues Cat and Gerry will be posting as well.
We remain committed to the agent community and providing a high level of service.
Thanks,
Ning
p.s. I did want to answer a few quick questions that came up earlier:
1) For ESI, if the wife is eligible but the husband is not, the spouse's portion of the premium is not subsidy-eligible. This is reflected in the quoter, and will be handled soon in the enrollment flow.
2) A small percentage of apps are receiving net premium differences - we are implementing a data sync process now to reduce these substantially.
3) The income change in the filler is due to rounding - our federal backend integration does not accept cents, so we are forced to round on submission, on a per person basis. We will put in a safeguard for folks near the Medicaid / CHIP boundaries going forward.
We apologize for the delay in posting. We were caught off guard by yet another unprecedented wave of demand - we've received and submitted in excess of 40,000 policies from 3,000 FFM certified agents during the first week. We are watching this thread very closely, and will be deploying enhancements and fixes throughout the upcoming weeks.
I did want to give some quick updates on what we've released in the last few days:
1) Overhauled data to match HC.gov on benefits. We also audited availability on a per zip/county level and added/removed several carriers.
2) Updated plan detail displays to match your preferences when you are logged in.
3) Updated quoter for accuracy (3 dependent under 21 cap, etc.)
4) Added a Save and Resume feature throughout the entire process. Saved quotes / enrollments go into your leads page, and can be resumed from there.
Besides general fixes / reliability improvements, we have several enhancements coming out soon to improve the quoting, shopping and renewal process. if you have an app specific inquiry you can reach out to us at [email protected]. For general issues, please continue to post on the forum, so that we can update everyone at the same time - my colleagues Cat and Gerry will be posting as well.
We remain committed to the agent community and providing a high level of service.
Thanks,
Ning
p.s. I did want to answer a few quick questions that came up earlier:
1) For ESI, if the wife is eligible but the husband is not, the spouse's portion of the premium is not subsidy-eligible. This is reflected in the quoter, and will be handled soon in the enrollment flow.
2) A small percentage of apps are receiving net premium differences - we are implementing a data sync process now to reduce these substantially.
3) The income change in the filler is due to rounding - our federal backend integration does not accept cents, so we are forced to round on submission, on a per person basis. We will put in a safeguard for folks near the Medicaid / CHIP boundaries going forward.
catperez
Expert
- 29
Additional Minor UI updates:
• Zip Code and County is back up at the top of the Plans List Page
• Mobile / Tablet Responsive views cleaned up on mobile for the plan list and details pages
• Zip Code and County is back up at the top of the Plans List Page
• Mobile / Tablet Responsive views cleaned up on mobile for the plan list and details pages
Thank you SO much for per-PERSON deductibles on the "Consumer Quotes"!!!!!
We still get per-FAMILY deductibles on the "Agent Quotes", though...when there are more-than-2-family members quoted???????
Fix coming?
Or, do we have to KEEP struggling to find per-PERSON deductibles & MOOP?
This back-and-forth searching is wearing us out.
We desperately MISS the 2015 Sherpa experience!!!!!!!
We still get per-FAMILY deductibles on the "Agent Quotes", though...when there are more-than-2-family members quoted???????
Fix coming?
Or, do we have to KEEP struggling to find per-PERSON deductibles & MOOP?
This back-and-forth searching is wearing us out.
We desperately MISS the 2015 Sherpa experience!!!!!!!
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