Core Elements of Eligibility and Enrollment

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In the this 4-part core elements of eligibility and enrollment series for open enrollment for 2019 coverage, we discuss the premium tax credit eligibility and calculation, how to determine households and income, how health plans are designed, and some strategies to help people choose a plan that best meets their needs.

 

Part I: The Premium Tax Credit

Part I provides a detailed discussion of eligibility for the premium tax credit—including how offers of employer-sponsored insurance can affect eligibility—as well as how the credit is calculated.

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Part II: Determining Households and Income for PTC and Medicaid

Part II details the rules used to determine household size and explains what counts as income when determining eligibility for the premium tax credit and Medicaid.

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Part III: Plan Design

Part III provides an overview of health plan design — including cost-sharing charges in marketplace plans, eligibility for cost-sharing reductions, and how plan design affects costs for consumers — as well as discussing the expansion of skimpy plans.

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Part IV: Plan Selection Strategies

In a special presentation by Dave Chandrasekaran, a training consultant and certified application counselor, Part IV provides an in-depth lesson on effective strategies to support people with understanding how commercial insurance works, evaluating and comparing marketplace plans, and selecting the plan that best meets their families’ needs.

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