HealthSherpa

[FLM2]

I want to know how long it takes to get the SUBSIDY ELIGIBILITY LETTER. In one of the other HealthSherpa threads, Russell said that it took 2 hours for it arrive.

An applicant needs that subsidy $$$ amount before picking a plan to buy. I'm not going to sit there and eat dinner with a family for 2 hours while we wait for that letter to arrive in the e-mail from HealthSherpa.

One of us needs to do a S.E.P. application on HealthSherpa and report back.
ac

No SEP enrollments with Sherpa, they have said that for the past month.

It takes time to get the eligibility letter with them but you can do the enrollment with just the calculated amount. Both times I have done it with a SEP the apps went through as planned.

If you are looking for a real time solution while doing face to face you will likely be disappointed (JMO). My client base has chosen to work with me so isn't looking for a real time enrollment confirmation, they know I will follow up and make sure everything is OK, it's no different than apps taken when underwriting was in place.

 

[AllenChicago]

No SEP enrollments with Sherpa, they have said that for the past month.

It takes time to get the eligibility letter with them but you can do the enrollment with just the calculated amount. Both times I have done it with a SEP the apps went through as planned.

If you are looking for a real time solution while doing face to face you will likely be disappointed (JMO). My client base has chosen to work with me so isn't looking for a real time enrollment confirmation, they know I will follow up and make sure everything is OK, it's no different than apps taken when underwriting was in place.

I can't go with the subsidy "estimate" with my face-to-face enrollments. Some have ID Verification failures and many families get their kids kicked to Medicaid, which changes the entire configuration.

Guess I'll only use Sherpa for signature links and drop-cards. I wonder who will have the liability if the applicant picks a plan and finds out the next time he/she checks e-mail that subsidy $$ estimate was completely wrong due to children being deemed ineligible? Sherpa or Agent?

 

[Ann H]

It is my understanding that HealthSherpa's subsidy eligibility certifications will be instant in OEP this year, just like they were in OEP last year.

CMS ordered a rule that they can't process applications during SEP like they did in OEP, so that is the reason for the delayed subsidy eligibility certs right now.

 

[AllenChicago]

It is my understanding that HealthSherpa's subsidy eligibility certifications will be instant in OEP this year, just like they were in OEP last year.

CMS ordered a rule that they can't process applications during SEP like they did in OEP, so that is the reason for the delayed subsidy eligibility certs right now.

Ann, you have an excellent track record of accurate recollection and understanding. If we can put the horse before the cart by obtaining subsidy before picking a plan, that would be PERFECT, because the HealthSherpa interface and ease of navigation is state-of-the art simplicity. Thanks for the info!
-ac

 

[YouGotMyMoney]

I can't go with the subsidy "estimate" with my face-to-face enrollments. Some have ID Verification failures and many families get their kids kicked to Medicaid, which changes the entire configuration.

Guess I'll only use Sherpa for signature links and drop-cards. I wonder who will have the liability if the applicant picks a plan and finds out the next time he/she checks e-mail that subsidy $$ estimate was completely wrong due to children being deemed ineligible? Sherpa or Agent?

You should know before you submit the app if the kids are likely to get kicked off to medicaid/chips anyway, right?

 

[TxOnline]

You can do the entire app as practice no enrollments until OEP

Thanks, FLM2!!!!!!!

I set up my HealthSherpa account, did a practice app & here's what CLIENT see's on last screen:

Almost Done!

Thank you for your application. To complete your enrollment, we'll give you a quick call within one business day. The call should take less than 5 minutes.

If you don't hear from us in the next day, please give us a call at (MY Agency Phone Number listed HERE).

For reference, your confirmation id is xxxxxxxxxx.

**************

The Test Client didn't get an email.

I (the Agent) got THIS email from HealthSherpa:

Dear Test,

Thanks for submitting your application through HealthSherpa!
To complete your enrollment, please give us a phone call at your earliest convenience to set up a quick identity verification phone call. The call appointment should take less than 5 minutes. Contact one of our representatives at 866-796-xxxx.
(Asks the client to call HealthSherpa's number....not mine, like client was instructed on the LAST screen of their submission.)

When we are done, we will send you a confirmation email. Afterwards, the insurer will send you a welcome packet containing your proof of insurance, as well as instructions for paying your first month's premium.
For your records, your confirmation ID is xxxxxxxx.

If you have questions or would like to follow up, please feel free to call us at (866) 796-xxxx (HealthSherpa's telephone number) or email us at (HealthSherpa's email address here).

If you enjoyed applying for coverage through HealthSherpa, tell your friends! We want to make this process easy for as many people as possible.

Thanks,
The HealthSherpa Team

****************

Dashboard lists:
Applicant...Their Ph #...Plan/Co chosen...Effective date 11/1...Submit Date

****************

Lightning FAST !!!!!!!
Less-than 5 minutes to submit app!

Excellent job keeping things SIMPLE (...even the wording on site)!!!!!!!
Customer friendly!
Your customers CAN'T get lost (except when comparing plan choices).

Why would anyone pay hundreds-of-millions for a complex site that doesn't perform?
Other-people's-money! Incompetence at the highest level!

Ning & Company have a bright future ahead of them!!!!!!!
Thanks, Ning, for keeping us informed & for a superb site & concept!!!!!!!

...

 

[AllenChicago]

You should know before you submit the app if the kids are likely to get kicked off to medicaid/chips anyway, right?

YGMM, on HealthSherpa today entered data from a recent Special Enrollment Illinois family of 4 whose children were NOT sent to Medicaid. All four were allowed by HC.gov to be on the same private health plan and were subsidy eligible.

However, HealthSherpa said that the two children (ages 3 and 1) were not allowed to be on the family application and would need to apply to Medicaid. Because this reduced the family size from 4 to 2 for subsidy purposes, the $65,000 MAGI made the husband/wife ineligible for a subsidy.

I think HealthSherpa's strength of being very abbreviated in questioning is also a weakness in some family situations.

HC.gov asked what type of coverage this family had. I checked "coming off a group plan that was terminating". There are some nuances to the Medicaid law that allow children to stay with the parent(s), under certain circumstances.

HealthSherpa merely looks at the ages of the children, the income of the family and makes an instant determination. In this case, the children would not be included on whatever enrollment data was sent to the marketplace for subsidy eligibility and enrollment.

I enrolled two families this year who were referred to me by other agents because "something" on the internet told these families that their children had to go on Medicaid. I was able to get them on one family plan, but Now I'm starting to see how that can easily happen. Web-Brokers are geared to be as efficient as possible.
ac

 

[houcoogster]

However, HealthSherpa said that the two children (ages 3 and 1) were not allowed to be on the family application and would need to apply to Medicaid. Because this reduced the family size from 4 to 2 for subsidy purposes, the $65,000 MAGI made the husband/wife ineligible for a subsidy.

If this is true and you did everything correctly this is a HUGE PROBLEM!!!

Somebody more versed in Sherpa needs to respond to this. I will not use them if this is the case.

 

[nliang86]

Allen, you discovered a very subtle issue that we are addressing right now. Specifically, children that lost group insurance less than 3 months prior are not eligible for medicaid/CHIP in MI. We are adding this rule in now. I should note that you can still get the kids in on our application by marking them as in-eligible for medicaid. Once we have the rule above implemented, this will be automatic. Sorry about that, and we will get it fixed soon!

 

[houcoogster]

Allen, you discovered a very subtle issue that we are addressing right now. Specifically, children that lost group insurance less than 3 months prior are not eligible for medicaid/CHIP in MI. We are adding this rule in now. I should note that you can still get the kids in on our application by marking them as in-eligible for medicaid. Once we have the rule above implemented, this will be automatic. Sorry about that, and we will get it fixed soon!

Nliang86,

That's a rather small problem. The big problem is that the kids are not being included in the household for subsidy calculation.