What is Your One Suggested Modification for 2016

[G.Gordon]

Being able to change application content without going through the entire app or re-enrolling would be nice.

Two recent cases.

1. Middle initial was input as E instead of K. Client calls marketplace instead of me. Marketplace fixes it by totally redoing app, re-enrolling clients. The problem is they were in the same Gold plan, but seperated so their out of pocket and deductibles were considered seperate. They are now on one plan together. Trying to fix this before the 2/1 effective change is impossible.

2. Family of six. Mom, dad, two kids on medicaid, one college age daughter on x's employer plan, one 19 year old that makes enough and files own taxes and has own insurance. When she called the marketplace told her to include 19 year old son. Problem is, if she did, it counts his income and screws up the subsidy. He does not have to be included. We can't start a new application that doesn't already have his information prepopulated, nothing we can do to override this. So, I'm going to redo them today through h.sherpa hoping that will over write their file when I eventually link the new h.sherpa app to their h.gov account.

Simple fixes like this should not take so much time and effort.

 

[russelltw]

Agree, there should be just a few buttons when you start the enrollment process:
1 - Have any of the following changed on last year's app:(what you entered last year shows up)
- income estimate
- family make up
- job situation
- tax situation
- etc.
2 - Do you want to keep your plan from last year?
system shows next years premium and a button to change plans.
3 - Button to confirm that agent/broker is assisting you and you give them the right to sign this information on your behalf.

If anything changes, you go to that portion of the app and edit it. Renewals could be done in 5 minutes in most cases.

 

[somarco]

Get rid of navigators and enrollment assister's and anyone else that has been anointed because they took a 40 hour class in Obamacare 101.

 

[bluediamond]

Same as above I can't count the times someone has called me and has already dealt with an assister or navigator and had everything screwed up.

 

[Ann H]

Get rid of the exchange altogether. It is an unneeded third party, which charges a commission. Well, they call it a "fee", LOL, but it's as large as our commissions! Why do we need an exchange at all? Tax favored HSA's didn't need an exchange. Employer tax credits didn't need an exchange. Here in AZ we have had an ADVANCED tax credit for years for groups and low-income individuals, and it is a one page application, resulting in a one page certificate, which have all been processed smoothly. The exchange is nothing but a government insurance agency and it is unnecessary.

 

[FLM2]

Get rid of the exchange altogether. It is an unneeded third party, which charges a commission. Well, they call it a "fee", LOL, but it's as large as our commissions! Why do we need an exchange at all? Tax favored HSA's didn't need an exchange. Employer tax credits didn't need an exchange. Here in AZ we have had an ADVANCED tax credit for years for groups and low-income individuals, and it is a one page application, resulting in a one page certificate, which have all been processed smoothly. The exchange is nothing but a government insurance agency and it is unnecessary.

Get rid of using the estimated income for the next year and base it on the last tax return that has been filed.

Provide a process for an appeal process to lower your income if your situation has changed substantially due to job loss or changed situation.

That eliminates all of this clawback crap and provides a guaranteed subsidy that doesn't change in midyear and drive everyone crazy.

There also needs to be an easier mechanism to make changes, what exists now is the worst I could ever imagine.

 

[kgmom219]

Get rid of using the estimated income for the next year and base it on the last tax return that has been filed.

Provide a process for an appeal process to lower your income if your situation has changed substantially due to job loss or changed situation.

That eliminates all of this clawback crap and provides a guaranteed subsidy that doesn't change in midyear and drive everyone crazy.

There also needs to be an easier mechanism to make changes, what exists now is the worst I could ever imagine.

This actually shouldn't be THAT difficult. CMS (or Social Security?) is already doing it for people on the Part B premium if you are over $85/170K.

The problem is that it takes 12-16 weeks, AFTER you are approved to file for an appeal.

 

[FLM2]

This actually shouldn't be THAT difficult. CMS (or Social Security?) is already doing it for people on the Part B premium if you are over $85/170K.

The problem is that it takes 12-16 weeks, AFTER you are approved to file for an appeal.

It isn't really a problem-the small percentage of people that would file an appeal could be given a pending subsidy that they would have to pay back if the appeal is declined-then it is the choice of the consumer.

Having a process that affects everyone and puts everyone in jeopardy just makes no sense whatsoever. It also costs the government a small fortune to administer it.