Washington Health Benefit Exchange

Transcription

1 Washington Health Benefit Exchange Tribal Assister Touch Base Call February 20, 2018

2 Introductions Deb Sosa, Tribal Liaison, HBE Vicki Lowe, Executive Director - AIHC Monica Chambers, Senior Administrative Assistant, HBE 2

3 10:00 Welcome and Roll Call 10: A Resources Tribal Assister Call February 20, 2018 Agenda 10:15 Conditional Eligibility Verification 10:25 Enrollment Knowledge Transfers 10:35 Tobacco Use Premium Rates 10:45 Insurance Carrier Fair Training 10:50 Open Discussion 11:00 Adjourn 3

4 Washington Health Benefit Exchange 1095-A Resources Deb Sosa

5 1095-A Available in Washington Healthplanfinder Saturday, January 20,; clients who were enrolled in a Qualified Health Plan during 2017, received notice that their 1095-A is available in their Washington Healthplanfinder message center. For clients who have selected mail notification preference, the hard copy mailing with infographic insert is expected to have gone out via USPS. 5

6 Materials Related to 1095-A and the upcoming Tax Season: Infographic Example 1095-A Tax Resources (links to irs.gov) 1095-A FAQs Blog on the 1095-A, B, & C 1095-A information slides Affordability Exemption Information and Calculator 6

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8 Correcting a 1095-A If your client believes their 1095-A is incorrect, they may fill out a correction request online. PLEASE NOTE: The 1095-B and 1095-C are outside the purview of Washington Health-planfinder. The Washington State Health Care Authority is handling the mailing and customer support for 1095-Bs which will be sent to Washington Apple Health clients. More information about their process is available here. 8

9 Tax Credits Clients that took advance payments of tax credits are required to reconcile their taxes and file form If advance premium tax credit is more than premium tax credit, the individual has received excess advance premium tax credit and must repay the excess (subject to repayment limitations). If premium tax credit is more than advance premium tax credit, the individual will receive an increased refund for the difference (or reduction in tax payment due). Clients that did not take advance payments of the tax credit, may claim all of their tax credit. Even those clients that did not seek financial assistance. 9

10 Washington Health Benefit Exchange Conditional Eligibility Verification Deb Sosa

11 When my client calls, how can I figure out what s going on? Check your clients Message Center the letters or s that the CEV Team sends are posted here Visit your clients Document Center required documents will be noted for each household member that is conditional Verify that your clients documentation will satisfy their Document Category (income documents must prove attested income within 10%).

12 CEV When my client calls, how can I figure out what s going on? Check your clients Message Center the letters or s that the CEV Team sends are posted here Visit your clients Document Center required documents will be noted for each household member that is conditional Verify that your clients documentation will satisfy their Document Category (income documents must prove attested income within 10%). If the late document resolves the inconsistency the CEV team will reinstate their tax credit eligibility. Actions follow the 15th rule. We are not able to reinstate the original enrollment nor apply tax credits retroactively. 12

13 Missed Verification Deadline? There are significant negative impacts to clients who do not respond before the deadline! Your client will either lose eligibility to purchase insurance through Washington Healthplanfinder and be disenrolled, or see a change in or lose tax credits Unless they are an enrolled AI/AN member. 1. Inform your client to upload the required documentation as soon as possible. You should verify that they have uploaded the correct document for the category that are conditional for. 2. Call center support will follow up with you once the ticket has been solved 3. Your client will receive an updated Eligibility Results letter posted to their Message Center with more information *Review the Acceptable Documents for Conditional Eligibility guide if you are unsure what documents your client needs to submit 13

14 Washington Health Benefit Exchange Enrollment Knowledge Transfers Deb Sosa

15 Training Opportunities. Enrollment Knowledge Transfers Please join us bi-weekly to discuss hot enrollment topics! Mar 8, :15pm 12:45pm Apr 12, :15pm 12:45pm May 10, :15pm 12:45pm 15

16 Washington Health Benefit Exchange Tobacco Use Premium Rates Deb Sosa

17 Tobacco Use Premium Rates If client reports they were using tobacco products, they will be required to pay a higher premium. Tobacco use is typically defines as any tobacco product, including cigarettes, cigars, chewing tobacco, snuff, and pipe tobacco, used four or more times a week within the past 6 months. The ACA allows for insurance companies to charge tobacco users up to 50% more than non-tobacco users. Tax credits are not applied to the increased premium from the tobacco use rating. If your client is enrolled in 2018 coverage as a tobacco user Once they have been tobacco use free for 6 months, they can report a change and update their application to a non-tobacco user. Change will not be reflected in the files sent to the carrier, so it is important that you producer@wahbexchange.org to request a ticket. A manual change file will be sent to the carrier with the non-tobacco premium rate. *Per the IRS: Facts about the Premium Tax Credit 17

18 Washington Health Benefit Exchange Insurance Carrier Fair Training Vicki Lowe

19 AIHC Tribal Assister IP Training Agenda April 25,

20 AIHC Tribal Assister IP Training Agenda April 26, 2018

21 Washington Health Benefit Exchange Open Discussion

22 Washington Health Benefit Exchange Upcoming Agenda

23 Agenda Items for March 2018 Tribal Assister Call Any new agenda topic requests? Review of Online Navigator resources? Please feel free to invite staff that might find this information useful 23

24 Questions 24

25 Contacts: Deb Sosa, Tribal Liaison Paul Tucker, Operations Program Coordinator Monica Chambers, Senior Administrative Assistant, Policy