How Are People Canceling Previous Plans when Using Web Broker to Enroll?

[Duaine]

My questions exactly. What a mess . . . .you would think they could simply bang the SSN up against the account & auto dis-enroll the previous plan in the same way that they do that with the Medicare number for part D. I'm amazed that they didn't include this type of feature. I've seen no written guidance on any of this . . .

Just got this from Kenny at ACA Express:


On 11/20 CMS sent out an email to agents/brokers that stated "If an application submitted via Direct Enrollment last year is not touched by you this year, the auto re-enrolled application may not contain your NPN; thus, this NPN may not be included in the enrollment transaction sent to the issuer." On Tuesday's Issuer Enrollment Policy call an issuer reported that on many of its BAR (batch auto renewal) Wave 1 transactions did not have NPN/agent information included. Some members of AWHIB raised this issue with CMS on Tuesday's Issuer Technical Workgroup Call. Andrew Rumin confirmed that due to how the FFM is architected, applications submitted through the Batch Auto Renewal Wave 1 (which is about 80% of all auto reenrollments) will have NPNs stripped from it.

 

[HealthGuy]

dont know if I believe this...this didnt seem to happen last year, why NOW?

 

[Yagents]

I think this is where the (PITA) double redirect with HS comes in, and probably why it was mandated.

Through the FFM with HS now, I go in and search for the 2016 pre-loaded app and pull it in to work from. I review the app and make changes as needed. I am not creating new 2016 apps.

I have gone back to check on these apps later and they do show the new coverage chosen through HS effective 1/1/2016, as well as showing the termination of the current coverage 12/31/15, same carrier or not.

Before HS started the double redirect, I was only using it for apps where I knew a 2015 app did not exist (or where the 2015 carrier had pulled from the market), so there wouldn't be a 2016 app to deal with for that very reason.

Am I doing it completely wrong?

pretty much spot on with how I'm approaching each client. Thank goodness most of my clients are being terminated (can't believe I just said that)

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Just got this from Kenny at ACA Express:


On 11/20 CMS sent out an email to agents/brokers that stated "If an application submitted via Direct Enrollment last year is not touched by you this year, the auto re-enrolled application may not contain your NPN; thus, this NPN may not be included in the enrollment transaction sent to the issuer." On Tuesday's Issuer Enrollment Policy call an issuer reported that on many of its BAR (batch auto renewal) Wave 1 transactions did not have NPN/agent information included. Some members of AWHIB raised this issue with CMS on Tuesday's Issuer Technical Workgroup Call. Andrew Rumin confirmed that due to how the FFM is architected, applications submitted through the Batch Auto Renewal Wave 1 (which is about 80% of all auto reenrollments) will have NPNs stripped from it.

This is a BIG problem. I called Aetna today to verify this very issue. Aetna is mapping plans in 16' in FL. I've actively re-enrolled 1/2 my book, and they are all coming thru with NPN. BUT, for those apps that I used Sherpa, and PASSIVELY renewed for 2016, my NPN is NOT showing on the 16' app from the Oct 20th BAR file.

Better re-enroll all of your Sherpa'd mapping over clients by the 15th. Aetna rep also said they have a new clause on the AOR form stating no more AOR changes after Jan 31st. Haven't read or seen it yet. Another way to cut us out.

Not cool.

So, does this email above mean they are aware of the situation, and will correct it with the final BAR file sent on Dec 16th..... with our NPN's?????

 

[cadylou]

pretty much spot on with how I'm approaching each client. Thank goodness most of my clients are being terminated (can't believe I just said that) ---------- This is a BIG problem. I called Aetna today to verify this very issue. Aetna is mapping plans in 16' in FL. I've actively re-enrolled 1/2 my book, and they are all coming thru with NPN. BUT, for those apps that I used Sherpa, and PASSIVELY renewed for 2016, my NPN is NOT showing on the 16' app from the Oct 20th BAR file. Better re-enroll all of your Sherpa'd mapping over clients by the 15th. Aetna rep also said they have a new clause on the AOR form stating no more AOR changes after Jan 31st. Haven't read or seen it yet. Another way to cut us out. Not cool. So, does this email above mean they are aware of the situation, and will correct it with the final BAR file sent on Dec 16th..... with our NPN's?????

So for those who don't want to make changes we lose credit? If so, I'm not going to bother talking to anybody and tell them in leaving the individual market. UGH!!

 

[AllenChicago]

I just went back to 11/20/15 e-mail and found the notice. Didn't pay much attention to it, because like HealthGuy said, there were no widespread problems with 2014 to 2015 renewals having NPN's stripped. But this year, CMS is saying, "If you want to ensure that you get paid, you gonna have to work for it...fool!"

---Start Copy/paste---

Agents/Brokers: Important NPN Tips for Re-enrollments

"The Centers for Medicare & Medicaid Services (CMS) would like to provide you with a few tips to ensure that your National Producer Number (NPN) is retained when your clients re-enroll in coverage through the Marketplace for plan year 2016.

Please note that the following guidance applies only to the Marketplace for Individuals and Families. NPNs are automatically carried over when agents and brokers assist small employers when logged into the Small Business Health Option Program (SHOP) Marketplace Agent/Broker Portal.

· Tip #1: When helping a consumer use the "Side-by-Side" (i.e., Marketplace) enrollment pathway at HealthCare.gov, check to see if your NPN is included on the application. If not, have the consumer enter it before the consumer closes out the application. Ensure the consumer enters the correct NPN and then direct the consumer to click "Save & Continue" to move forward. If contacting the Marketplace Call Center about a consumer's application, ensure your NPN is still associated with the application. If your NPN is not there, consumers may have the Marketplace Call Center add or re-enter your NPN to an application when making updates to it.

· Tip #2: When helping a consumer with a renewal for plan year 2016 using the Direct Enrollment pathway, make sure to move the consumer through "Report a Life Change" to make updates and confirm information. If an application submitted via Direct Enrollment last year is not touched by you this year, the auto re-enrolled application may not contain your NPN; thus, this NPN may not be included in the enrollment transaction sent to the issuer. If you continue to the partner (i.e., issuer or web-broker) website after helping the client use "Reporting a Life Change" and selecting the same or a new qualified health plan (QHP), your NPN will be generated on the enrollment transaction sent to the issuer.

If you have a legitimate reason to believe you should be credited for a Federally-Facilitated Marketplace (FFM) enrollment, but have not been credited for it, you should contact the respective QHP issuer directly to discuss the specific situation. If the QHP issuer believes you did, in fact, assist a consumer, but the NPN was erroneously left off of the enrollment transaction, the QHP issuer may pay the commission accordingly. Please note that agents and brokers must meet registration requirements prior to assisting with an FFM application to be credited for the enrollment transaction. For more information about plan year 2016 FFM registration requirements, please visit the Agents and Brokers Resources webpage.

For general questions about the agent and broker program, please email the FFM Producer and Assister Help Desk at [email protected]. You may also contact the Agent and Broker Call Center by calling 1-855-CMS-1515 (855-267-1515) and selecting option "1." Call Center Representatives will be available Monday through Saturday from 8:00 AM to 10:00 PM Eastern Time (ET) and will also be available during limited hours on Sundays and holidays through November. Please note that this call center will not have access to consumer information and will not be able to handle specific questions or issues with a consumer's application. Agents and brokers should continue to call the Marketplace Call Center at 1-800-318-2596 for assistance related to enrolling consumers into coverage through the Individual Marketplace. For assistance related to coverage through the SHOP Marketplace, contact the SHOP Call Center at 1-800-706-7893."

 

[cadylou]

I just went back to 11/20/15 e-mail and found the notice. Didn't pay much attention to it, because like HealthGuy said, there were no widespread problems with 2014 to 2015 renewals having NPN's stripped. But this year, CMS is saying that, "If you want to ensure that you get paid, you gonna have to work for it...fool!" ---Start Copy/paste--- Agents/Brokers: Important NPN Tips for Re-enrollments "The Centers for Medicare & Medicaid Services (CMS) would like to provide you with a few tips to ensure that your National Producer Number (NPN) is retained when your clients re-enroll in coverage through the Marketplace for plan year 2016. Please note that the following guidance applies only to the Marketplace for Individuals and Families. NPNs are automatically carried over when agents and brokers assist small employers when logged into the Small Business Health Option Program (SHOP) Marketplace Agent/Broker Portal. · Tip #1: When helping a consumer use the "Side-by-Side" (i.e., Marketplace) enrollment pathway at HealthCare.gov, check to see if your NPN is included on the application. If not, have the consumer enter it before the consumer closes out the application. Ensure the consumer enters the correct NPN and then direct the consumer to click "Save & Continue" to move forward. If contacting the Marketplace Call Center about a consumer's application, ensure your NPN is still associated with the application. If your NPN is not there, consumers may have the Marketplace Call Center add or re-enter your NPN to an application when making updates to it. · Tip #2: When helping a consumer with a renewal for plan year 2016 using the Direct Enrollment pathway, make sure to move the consumer through "Report a Life Change" to make updates and confirm information. If an application submitted via Direct Enrollment last year is not touched by you this year, the auto re-enrolled application may not contain your NPN; thus, this NPN may not be included in the enrollment transaction sent to the issuer. If you continue to the partner (i.e., issuer or web-broker) website after helping the client use "Reporting a Life Change" and selecting the same or a new qualified health plan (QHP), your NPN will be generated on the enrollment transaction sent to the issuer. If you have a legitimate reason to believe you should be credited for a Federally-Facilitated Marketplace (FFM) enrollment, but have not been credited for it, you should contact the respective QHP issuer directly to discuss the specific situation. If the QHP issuer believes you did, in fact, assist a consumer, but the NPN was erroneously left off of the enrollment transaction, the QHP issuer may pay the commission accordingly. Please note that agents and brokers must meet registration requirements prior to assisting with an FFM application to be credited for the enrollment transaction. For more information about plan year 2016 FFM registration requirements, please visit the Agents and Brokers Resources webpage. For general questions about the agent and broker program, please email the FFM Producer and Assister Help Desk at [email protected]. You may also contact the Agent and Broker Call Center by calling 1-855-CMS-1515 (855-267-1515) and selecting option "1." Call Center Representatives will be available Monday through Saturday from 8:00 AM to 10:00 PM Eastern Time (ET) and will also be available during limited hours on Sundays and holidays through November. Please note that this call center will not have access to consumer information and will not be able to handle specific questions or issues with a consumer's application. Agents and brokers should continue to call the Marketplace Call Center at 1-800-318-2596 for assistance related to enrolling consumers into coverage through the Individual Marketplace. For assistance related to coverage through the SHOP Marketplace, contact the SHOP Call Center at 1-800-706-7893."

Wow!! Screw them! Too bad for the consumer who needs more help than ever noes. Guess il go through my book and send notification to those I can no longer help in the future. I'm not a social worker.

 

[houcoogster]

I just went back to 11/20/15 e-mail and found the notice. Didn't pay much attention to it, because like HealthGuy said, there were no widespread problems with 2014 to 2015 renewals having NPN's stripped. But this year, CMS is saying, "If you want to ensure that you get paid, you gonna have to work for it...fool!"

---Start Copy/paste---

Agents/Brokers: Important NPN Tips for Re-enrollments

"The Centers for Medicare & Medicaid Services (CMS) would like to provide you with a few tips to ensure that your National Producer Number (NPN) is retained when your clients re-enroll in coverage through the Marketplace for plan year 2016.

Please note that the following guidance applies only to the Marketplace for Individuals and Families. NPNs are automatically carried over when agents and brokers assist small employers when logged into the Small Business Health Option Program (SHOP) Marketplace Agent/Broker Portal.

· Tip #1: When helping a consumer use the "Side-by-Side" (i.e., Marketplace) enrollment pathway at HealthCare.gov, check to see if your NPN is included on the application. If not, have the consumer enter it before the consumer closes out the application. Ensure the consumer enters the correct NPN and then direct the consumer to click "Save & Continue" to move forward. If contacting the Marketplace Call Center about a consumer's application, ensure your NPN is still associated with the application. If your NPN is not there, consumers may have the Marketplace Call Center add or re-enter your NPN to an application when making updates to it.

· Tip #2: When helping a consumer with a renewal for plan year 2016 using the Direct Enrollment pathway, make sure to move the consumer through "Report a Life Change" to make updates and confirm information. If an application submitted via Direct Enrollment last year is not touched by you this year, the auto re-enrolled application may not contain your NPN; thus, this NPN may not be included in the enrollment transaction sent to the issuer. If you continue to the partner (i.e., issuer or web-broker) website after helping the client use "Reporting a Life Change" and selecting the same or a new qualified health plan (QHP), your NPN will be generated on the enrollment transaction sent to the issuer.

If you have a legitimate reason to believe you should be credited for a Federally-Facilitated Marketplace (FFM) enrollment, but have not been credited for it, you should contact the respective QHP issuer directly to discuss the specific situation. If the QHP issuer believes you did, in fact, assist a consumer, but the NPN was erroneously left off of the enrollment transaction, the QHP issuer may pay the commission accordingly. Please note that agents and brokers must meet registration requirements prior to assisting with an FFM application to be credited for the enrollment transaction. For more information about plan year 2016 FFM registration requirements, please visit the Agents and Brokers Resources webpage.

For general questions about the agent and broker program, please email the FFM Producer and Assister Help Desk at [email protected]. You may also contact the Agent and Broker Call Center by calling 1-855-CMS-1515 (855-267-1515) and selecting option "1." Call Center Representatives will be available Monday through Saturday from 8:00 AM to 10:00 PM Eastern Time (ET) and will also be available during limited hours on Sundays and holidays through November. Please note that this call center will not have access to consumer information and will not be able to handle specific questions or issues with a consumer's application. Agents and brokers should continue to call the Marketplace Call Center at 1-800-318-2596 for assistance related to enrolling consumers into coverage through the Individual Marketplace. For assistance related to coverage through the SHOP Marketplace, contact the SHOP Call Center at 1-800-706-7893."

So we need to go into each clients app and do this before Dec 15th??????

 

[Duaine]

Here are some updates:

CMS tips: How to keep HealthCare.gov from forgetting you | LifeHealthPro

 

[cadylou]

There's just not enough alcohol in the world for this! It's a losing proposition all around. They kept agents in the first couple of years because they needed to get enrollment numbers up. Now --we've served our purpose and are expendable. No more for me--I'll keep off exchange only. . .till they stop paying us for that. Then it's"goodbye under 65". Very sad -- our services are more important than ever since its so hard to decipher nuances like narrow networks and plans with no out of network coverage. Guess people will find out when they buy land on their own and the plan doesn't function for them . . .

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There's just not enough alcohol in the world for this! It's a losing proposition all around. They kept agents in the first couple of years because they needed to get enrollment numbers up. Now --we've served our purpose and are expendable. No more for me--I'll keep off exchange only. . .till they stop paying us for that. Then it's"goodbye under 65". Very sad -- our services are more important than ever since its so hard to decipher nuances like narrow networks and plans with no out of network coverage. Guess people will find out when they buy land on their own and the plan doesn't function for them . . .

I meant buy plans -- not land on their own . . .

 

[mschlange]

There has been so much comment on this topic and is a area of concern.
Do we say go in and delete the duplicate application or write a new app and hope the latest application over rules.
Coventry is only getting one application and refuses to acknowledge getting the new application with the npn number and says its HC fault and you call HC and they have just one policy the one with the npn number
I would like to know what others are doing and what works