Health Sherpa

[nliang86]

We will have multiple enrollment groups soon - it's a relatively rare case so we've prioritized some other cases (employer sponsored insurance subsidy estimates, etc.), but we will get to it soon, likely around the same time as dental plans.

 

[CHUMPS FROM OXFORD]

Ning...Two very serious questions.

First...How did Yale lose to Harvard a few weekends ago? At 8-1, I thought they could handle unbeaten Harvard.

Secondly...I have notices that sometimes after an app is submitted, the subsidy comes back lower for no apparent reason. The income and ages match the initial subsidy quote I get from your quotes. But then the offer shows a lower subsidy which seems incorrect. If the client accepts, I'm not sure it will correct itself.

Thanks

 

[nliang86]

The cases of a subsidy being lower than expected are usually due to the federal hub finding prior income records, and using those to derive an income rather than taking what the consumer reports. We do attempt everything possible to get the consumer's stated income accepted, but at the end of the day the hub has the final call.

This can even affect medicaid / CHIP eligibility - the higher income lifts children out of medicaid / CHIP. It's rare but does occur occasionally.

If the consumer's income at end of year matches what they stated, they will get the difference on their tax return. If they end up owing money the government (income higher than stated or last year), there are limits on how much they have to repay, mainly to protect lower income folks. Here's a summary of how that works:

Will I Have to Pay Back my Tax Credit? - HealthSherpa

Thanks,
Ning

p.s. Yale came close, and the Ivy League was very strong this year

 

[AllenChicago]

Allen - we have added a question for children that have been rejected from or lost medicaid / chip - it's at the bottom of each person's section on the household page. The application flow will properly update your quote (i.e. put the kids back onto the policy).

Re: kids that have not been rejected or lost medicaid / chip yet - the result in our system and healthcare.gov will be identical - you will see an entry in your dashboard indicating that everyone can be on the plan, and asking you to approve the submission.

Plan selection is automatic and based on the HIOS ID of the plan, so there is no potential for human error.

Ning

Hey Ning. Thanks (once again) for promptly responding to our concerns.

I've seen the "Rejected/Lost Medicaid or Chip after October 2014" check-markable item, but have not run into any of those yet. It's strange that HC.gov picks that recent date for the front end of the eligibility window isn't it?

Ning, you need to elaborate on your comment about children that have NOT been rejected by Medicaid/CHIP. In Illinois, HealthSherpa doesn't allow me to even quote children on the family plan for middle income families. (Example: Chicago Zip 60606 / Parent-35 / Child-10 / Income-$45000 = "Child is not eligible to be on the plan". ) Are you saying there's a way to override this on the front (quoting) end of Health Sherpa somehow?

Thank-you for affirming that choosing of the plan is 100% automated, Ning.

-Allen

 

[CHUMPS FROM OXFORD]

I appreciate the quick responses.

 

[nliang86]

We apologize for that - we had to balance simplicity vs. handling edge cases on the frontend quoter, since that is where the majority of consumers spend their time. A simple work around is to use age 19 for all children. Rates don't vary below age 20 anyway, so you can see what the cost will be if the kids were to be on the plan.

On the application itself, we will still do the medicaid / CHIP check. You can override this if the person has been rejected or lost medicaid / CHIP. If not, we still allow you to submit with the kids applying, and if Healthcare.gov does give them eligibility based on a higher previous income, you will be able to approve and enroll from your dashboard.

Ning

 

[TXINSURANCE]

Coventry also shows no apps in their system...I'm not going to bother checking with the "other" BCBS here as they are the worst company ever and guaranteed to screw up everything.

Pretty sure coventry and aetna won't show until payment is processed...

 

[dgoldenz]

Pretty sure coventry and aetna won't show until payment is processed...

Good to know, I'll have to call them

 

[AllenChicago]

We apologize for that - we had to balance simplicity vs. handling edge cases on the frontend quoter, since that is where the majority of consumers spend their time. A simple work around is to use age 19 for all children. Rates don't vary below age 20 anyway, so you can see what the cost will be if the kids were to be on the plan.

On the application itself, we will still do the medicaid / CHIP check. You can override this if the person has been rejected or lost medicaid / CHIP. If not, we still allow you to submit with the kids applying, and if Healthcare.gov does give them eligibility based on a higher previous income, you will be able to approve and enroll from your dashboard.

Ning

I understand the required balance with quoting. You don't want to instill false hope in families, only to have it dashed on the back end.

Ning, now that you've explained the best work-around using Health Sherpa, I'll give it a try with my next family applicant. The more I use HealthSherpa, the more I dread using HealthCare.flub. Thanks again!
-Allen

 

[Yagents]

What other carriers require this extra step besides Humana?

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ITEM 2: ATTRIBUTION ON COMPLETED APPLICATIONS

Certain carriers(e.g. Humana) require you to go through additional steps in the "Pay Premiums" section of Healthcare.gov to finalize an application and properly attribute it to you.

Here's how to do it:

1) Log in to your HealthSherpa dashboard,
2) Click on each submitted (white) application
3) Click "ACCESS ACCOUNT" for every completed application.
4) Log in to Healthcare.gov.
5) Look up application.
6) Click "Pay Premiums" and follow instructions to set up payment for the client.