In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 14, 2021, in partnership with the American Association on Health and Disability, Karl Cooper, Director of Public Health Programs at AAHD, discusses disability etiquette and basic accessibility considerations for anyone doing enrollment work.

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Knowing the Audience

• Health Disparities for People with Disabilities
• Disability Across the Lifespan

Disability Etiquette

• Disability Etiquette By Disability Category
• Accessibility Challenges When Planning & Hosting An Event
• Accessibility in a Virtual World
• Zoom Accessibility

Tips for Assisting People with Disabilities in the Plan Selection Process

• What the ACA Means for People with Disabilities
• Items to Consider in the Plan Selection Process
• Health Insurance Jeopardy

Resources Available from the National Disability Navigator Resource Collaborative

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 12, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, brings together all of the policies covered in our webinar series by walking through the HealthCare.gov application step-by-step.

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Scenario 1: The Maroney Family

• Automatic redeterminations & renewals
• Changing plans
• Updating income
• Data matching issues

Scenario 2: The Hernandez/Rosta Family

• Determining household composition & size
• Determining income
• Impact of employer-sponsored insurance
• Eligibility for APTC & Medicaid/CHIP

Scenario 3: The Ryan Family

• Calculating self-employment income
• Entering income
• Reporting tobacco use
• Plan selection
• PTC reconciliation

Additional Resources

OE9 Webinar Series

Resources for Determining Household Size

Resources for Calculating Income

Resources for the Marketplace

Resources for Comparing Marketplace Plan Options

Resources for Immigrant Eligibility & Enrollment

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 7, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, provides an in-depth overview of the HealthCare.gov auto-renewal process for 2022 coverage, including the process for plan enrollment and redetermination of premium tax credit eligibility.

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Active Re-enrollment

• Importance of Returning to the Marketplace

Redetermination of APTC by HealthCare.gov

• Redetermination Process for HealthCare.gov
• Notices About Redetermination Process
• Who is Eligible for Redetermination of APTC
• Who is Not Eligible for Redetermination of APTC
• Who is Not Eligible for Auto-Renewal
• How APTC and CSR are Redetermined

Auto-Enrollment for 2022 Plans in HealthCare.gov

• Three Possible Auto-Enrollment Options
• SEP When Auto-Enrolled in New Plan
• Notices About Renewal Process
• Terminating Coverage
• Tips for Assisters

Additional Resources

Key Facts About Auto-Renewal of Premium Tax Credits

Key Facts About Past Due Premiums

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities, in partnership with Foundation Communities, on October 5, 2021, Arianna Anaya covers strategies to help consumers understand how insurance works, evaluate and compare marketplace plans, and select the plan that best meets their families’ needs.

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Part I: Using the Enrollment Process to Explain Exchange Plans

• The Marketplace Enrollment Checklist
• Estimating Total Annual Cost
• Choosing the Amount of PTC to Use
• Checking Network & Rx Coverage
• Choosing a Health Plan

Part II: Plan Comparison Strategy

• Talking About Cost & Network
• Essential Health Benefits
• Comparing Plans Based on Cost
• Comparing Plans Based on Network
• Narrowing Plan Selection
• Cost-Sharing & Metal Tiers

Part III: Plan Selection Tips & Tools for Assisters

• Building a Network Overview Cheat Sheet

Additional Resources

OE9 Webinar: Part V Health Insurance Plan Design

Plan Comparison Worksheet

Key Facts About Cost-Sharing Reductions

Key Facts About Cost-Sharing Charges

October 2021

When creating a new account on HealthCare.gov, individuals are required to verify their identity by answering a series of questions based on information in their credit report, such as former addresses, the bank where they have a mortgage or auto loan, or the year they signed up for a specific credit card.

HealthCare.gov allows two attempts to verify identity, if the individual fails both attempts they will not be allowed to submit their application until their identity can be verified.

This guide outlines the steps you should take to troubleshoot a failed identity verification.

Additional Resources

OE9 Webinar: Part IV Preventing & Resolving Data Matching Issues

Reference Guide to Immigration Documents

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 30, 2021, Inna Rubin covers the ins and outs of how health insurance plans work. She also provides an overview of the different types of cost-sharing charges consumers may encounter and how subsidies on the health insurance marketplace can reduce those costs.

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Elements of Qualified Health Plans (QHPs)

• Overview of QHPs
• Essential health benefits
• Overview of plan networks
• Overview of formularies
• Premiums & cost-sharing charges

Overview of Cost-Sharing Charges

• Types of cost-sharing charges
• Maximum out-of-pocket limit
• Summary of benefits & coverage
• Overview of family cost-sharing charges
• Surprise billing protections

Actuarial Value

• Overview of actuarial value
• Cost-sharing differences between metal tiers
• Impact of actuarial value on cost-sharing charges

Cost-Sharing Reductions

• Overview of cost-sharing reductions
• Examples of how cost-sharing reductions impact cost

Skimpy Plans

• Overview of skimpy plans
• Risks associated with skimpy plans
• Coverage restrictions and exclusions in short-term plans

Additional Resources

OE9 Webinar: Part VI Plan Selection Strategies

Plan Comparison Worksheet

Key Facts About Cost-Sharing Reductions

Key Facts About Cost-Sharing Charges

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 28, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, and Shelby Gonzales, Vice President for Immigration Policy, provide guidance on how to help consumers complete the Marketplace documentation requirements. They explain both how to prevent data matching issues from occurring and how to resolve them when they do occur.

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Overview of Data Matching Issues

• Use of electronic data matching & limitations
• What happens when there is a data matching issue
• Data matching issue notices

Verification of Citizenship & Immigration Status

• Citizenship verification process on the marketplace
• Reasons citizenship data matching may be unsuccessful
• Documents that can be used to verify citizenship
• Immigration status verification process on the marketplace
• Reasons immigration status data matching may be unsuccessful
• Documents that can be used to verify immigration status
• Examples

Verification of Household Income

• Reasons data matching may be unable to verify income
• General rules for income verification
• Documents that can be used to verify income
• Guide to resolving income data matching issues
• Examples

Verification of Other Minimum Essential Coverage

• Overview of minimum essential coverage data matching issues
• Periodic data matching notices

General Tips to Prevent & Resolve DMIs

• Tips to prevent data matching issues
• Tips to resolve data matching issues

Identity Proofing for HealthCare.gov

• Process for identity proofing
• Documents used for identity proofing
• Troubleshooting failed identity proofing

Additional Resources

Reference Guide to Immigration Documents

Yearly Income Guidelines and Thresholds

Troubleshooting Failed Identity Verification

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 24, 2021, in partnership with the National Immigration Law Center, Shelby Gonzales, Vice President for Immigration Policy, and Gabrielle Lessard, Senior Policy Attorney at the National Immigration Law Center, provide an overview of immigration status-related eligibility requirements for Medicaid, the Children’s Health Insurance Program, and for enrollment in marketplace plans.

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Eligibility for Marketplace Coverage Based on Immigration Status

• Immigration statuses eligible for marketplace coverage

Eligibility for Medicaid & CHIP Based on Immigration Status

• Immigration statuses eligible for Medicaid & CHIP
• 5-year bar in Medicaid & CHIP
• State residency for Marketplace, Medicaid, & CHIP
• Health coverage for people coming from Afghanistan

Other Important Eligibility Rules for Families that Include Immigrants

• Special premium tax credit rule
• Special marketplace rules for seniors
• Examples

Options for People Ineligible for Insurance Affordability Programs Due to Immigration Status

• Medicaid payment for emergency services
• People who are undocumented or have DACA status
• Programs that don’t restrict eligibility based on status
• Health services related to COVID-19

Public Charge Update

Navigating the Application Process

• How the marketplace verifies citizenship
• Documents that can be used to prove citizenship
• How the marketplace verifies immigration status
• Documents that can be used to prove immigration status

Additional Resources

Reference Guide to Immigration Documents

Key Facts: Immigrant Eligibility for Health Coverage Programs

Key Facts: Helping Families That Include Immigrants Apply for Health Coverage

In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 16, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, provides an in-depth review of eligibility rules for premium tax credits—including how offers of employer-sponsored insurance can affect eligibility—as well as how premium tax credits are calculated.

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Premium Tax Credit Eligibility

• What is the Premium Tax Credit (PTC)?
• PTC Eligibility Requirements
• Income Requirements
• Eligible Tax Filing Status
• Exceptions to Joint Filing Requirement for PTC
• Special Rule for Certain Immigrants
• Types of Minimum Essential Coverage (MEC)

Eligibility for Employer-Sponsored Insurance (ESI)

• Eligibility for ESI
• Affordability of ESI
• Minimum Value of ESI
• Health Reimbursement Arrangement (HRA)
• Reconciliation of Overlapping Coverage

Calculation of the Premium Tax Credit

• How is the PTC Calculated?
• Expected Premium Contribution
• Benchmark Plans
• Factors that Affect the Cost of Benchmark Plans & Premiums
• Reporting Changes that Impact PTC
• PTC Repayment Caps

Additional Resources

Yearly Income Guidelines and Thresholds

Employer Coverage & Premium Tax Credit Eligibility Guide

Minimum Essential Coverage Reference Chart

Health Care Assister’s Guide to Tax Rules

In this Beyond the Basics webinar presented on September 14, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, and Jen Wagner, Director of Medicaid Eligibility and Enrollment, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.

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Why Household Size & Income Matter

• ACA Eligibility Overview
• How the federal poverty line (FPL) effects expected premium contribution

Why Tax Filing Status Matters

• Overview of tax filing statuses
• Marital status and premium tax credits (PTC)
• Head of household questions
• Exceptions to the joint filing requirement for PTC

Determining Households for Premium Tax Credits

• Types of tax dependents

Determining Households for MAGI Medicaid

• Medicaid household rules

What Counts as Income for PTC and Medicaid

• Modified Adjusted Gross Income (MAGI)
• Rules for counting income
• Tips for counting self-employment income

Annual vs Monthly Income Counting

• Entering monthly income
• Entering annual income

Examples of Combining Household & Income Rules to Determine Eligibility

Additional Resources

Yearly Income Guidelines and Thresholds

Medicaid Household Rules

Determining Households for Medicaid and CHIP

Determining Households for PTC

Income Definitions for Marketplace and Medicaid Coverage

Self-Employment Income Estimator Tool

Health Care Assister’s Guide to Tax Rules