After the open enrollment season, people may encounter a variety of issues that could affect their ability to stay enrolled in health coverage. They might have data matching issues (DMIs) they need to address to finalize their enrollment, or they might need to file an appeal to resolve an enrollment issue.
During the year, an enrollee might need to update their application to reflect changes to their income or household size.
Toward the end of the year, enrollees may need help understanding the re-enrollment process for the following year.
In this Beyond the Basics webinar presented on October 1, 2024, Shelby Gonzales, Vice President for Immigration Policy, and Jenny Sullivan, Director of Health Coverage Access, provide guidance on how to help applicants complete the marketplace documentation requirements, particularly for citizenship and immigration status and income, and explain how to…
Updated August 2024 People who enroll in coverage through a health insurance marketplace must pay a monthly premium in order to effectuate and maintain their coverage. The following FAQ explains marketplace policies on premium payments, grace periods for people who do not pay premiums on time, and termination of coverage…
Updated August 2024 Insurers can no longer collect any past-due premiums from the last 12 months before allowing someone to enroll in a plan with the same carrier. The following FAQ explain what happens now if a person misses a premium payment. ↓ Download PDF What is a past-due premium? A…
Updated August 2024 Many non-citizens in the United States are eligible for health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or subsidized plans in the Affordable Care Act (ACA) Marketplaces. In Healthcare.gov, non-citizens applying for coverage for themselves are asked to select from a drop down list of…
February 2024 The Summary Benefits and Coverage (SBC) is a standardized document that health insurance issuers must provide for all private health plans they offer, including ACA marketplace plans. The SBC provides an overview of a health plan’s benefits, coverage, limitations, and exceptions (although not its premiums, as these can…
Este seminario web en español proveerá herramientas para facilitar el acceso a cobertura de salud para consumidores hispanos, como son: conceptos básicos sobre seguro médico, comparación de planes de salud, y cómo resolver los errores más comunes de elegibilidad que afectan a inmigrantes y familias de estatus migratorio mixto. Un…
In this Beyond the Basics webinar presented on October 24, 2023, Claire Heyison, Senior Policy Analyst for Health Insurance & Marketplace Policy, and Jenny Sullivan, Director of Health Coverage Access, bring together all of the policies covered in the Beyond the Basics webinar series by walking through a series of…
In this Beyond the Basics webinar presented on October 12, 2023, Jenny Sullivan, Director of Health Coverage Access provided an in-depth review of the HealthCare.gov renewal process for 2024 coverage, including redetermination of premium tax credit eligibility and plan enrollment. Webinar Resources ↓ Presentation Slides (PDF)
Updated October 2023 Each open enrollment period, people enrolled in an ACA marketplace plan have to renew their coverage for the coming year. This process has two parts: redetermination of eligibility (if the person is receiving APTC) and re-enrollment in a marketplace plan for the coming year. The following FAQ…
In this Beyond the Basics webinar presented on September 28, 2023, Shelby Gonzales, Vice President for Immigration Policy, and Jenny Sullivan, Director of Health Coverage Access, provide guidance on how to help applicants complete the marketplace documentation requirements and will explain how to prevent data matching issues from occurring and…
