Renewals Guide for Assisters Open Enrollment 2018

Transcription

1 Renewals Guide for Assisters Open Enrollment 2018 Version: 10/17/2017

2 Table of Contents The Basics... 3 Timeline for 2018 Renewals... 4 Consumer Renewal Notices for 2018 Open Enrollment... 5 Health Care Eligibility Renewal Notice... 6 Health Care Renewal Notice Health Care Notice (System generated manual renewal eligibility notice) Enrolled but No 2018 Eligibility Renewal Notice (No IC) Health Care Notice (System generated SEN) Plan Enrollment Notice (Confirmation) Assister Tips Resources NOTE: You can jump to a page if looking at this guide electronically. Hold CTRL while clicking on a topic, and you will be jumped to that page. Quick reference guides are created by the Instructional Design team in the MNsure BPMO office. Please MNsure_MNsureTraining@state.mn.us for any questions, requested changes or updates. Page 2 of 29

3 The Basics QHPs offered through MNsure can change from year to year. Carriers can choose on an annual basis the products they offer, and existing products can change or no longer be offered. Most consumers who are currently enrolled in a QHP through MNsure, will have their eligibility for 2018 coverage automatically updated, including updated tax credits. Most consumers will have an option to, without completing a new application: Automatically renew their existing coverage if it is still offered. Automatically enroll in a similar plan option if their existing plan is no longer available. Shop for a new plan if they want to change coverage. Report any changes/life events that may affect their eligibility. No Need to Re-apply Most consumers do not need to fill out a new application to receive updated eligibility or financial assistance. Passive Renewal of Coverage Many consumers can have coverage passively renewed. This means their QHP plan may be automatically renewed with updated eligibility, without taking any action. Page 3 of 29

4 Timeline for 2018 Renewals Below is a simplified timeline of the types of notices and when consumers can expect to receive them. A consumer could receive multiple notices prior to, and during open enrollment. All notices that are part of the renewal process are produced from the current information that is in the Minnesota Eligibility Technology System (METS) or the Enrollment System of Record (ESOR). If a consumer has reported a change after a notice is produced, the information may be outdated and a manual notice will likely be sent. September/October MNsure will undergo its 2018 QHP renewals process. October-December MNsure and DHS will jointly work the cases that cannot be automatically renewed. November 1 st 2017 through January 14 th 2018 Open Enrollment The Health Care Eligibility Renewal Notice will be sent to consumers when their eligibility has been automatically renewed for The Health Care Renewal Notice will be sent to consumers who cannot be automatically renewed due to potential public program eligibility. Consumers who fail to autorenew, and receive the Health Care Renewal notice will need to submit information before 2018 eligibility can be determined. There will be other consumers who fail to auto-renew and their cases will need to be manually processed by a worker before 2018 eligibility can be determined. December 20 th is the last day to select a plan for January 1 st coverage Consumers who have been renewed and who want to select a new plan using updated eligibility, can enroll. Consumer will be enrolled in their current plan for January 1 coverage if they did not change eligibility and haven t selected a new plan. Consumers who are newly eligible for QHP can enroll. Consumers who are QHP eligible but are not currently enrolled can enroll. Page 4 of 29

5 Consumer Renewal Notices for 2018 Open Enrollment This guide will show pertinent parts of the notices that are important for the renewal process. It does not include ALL pages or sections of the notices. These notices should never be reproduced for any reason. The notices for 2018 open enrollment are: 1. Health Care Eligibility Renewal Notice 2. Health Care Renewal Notice 3. Health Care Renewal Eligibility Notice (manual/renewal closures) 4. Standard Eligibility Notice for Open Enrollment 5. Plan Enrollment Notice (Confirmation) for Open Enrollment Page 5 of 29

6 Health Care Eligibility Renewal Notice Who gets this notice? This notice is mailed to consumers who are re-determined eligible for a qualified health plan in The notice will inform consumers of any updated tax credit amounts. This group can include consumers who are not currently enrolled, but have applied previously with MNsure. The notice will be viewable in the consumer's online account. DO NOT create a new account for any consumers that are in this category. What should the consumer do? The notice contains current data from the consumer account that the consumer should review for accuracy, such as the amount of next year's projected annual income. Consumers who receive this notice should NOT send this form back, but have the following options: If consumers have no changes to report, they do not need to take any action. They will be automatically re-enrolled into their current plan if offered, or can choose to shop for a new plan during open enrollment. If consumers have a change to report, they can call MNsure Contact Center. Eligibility will be re-determined, and the consumer can then shop for a QHP during open enrollment, or will receive notice for MinnesotaCare or Medical Assistance if eligible. What happens next? If the consumer does not take any action, they will be automatically enrolled into their current plan. The consumer can choose to shop and enroll in a new plan during Open Enrollment The consumer can report a change by calling the Contact Center, and eligibility will be redetermined. Based on their new eligibility they can enroll in a QHP or will receive notification for MinnesotaCare or Medical Assistance. Page 6 of 29

7 Page 7 of 29

8 Eligibility status and coverage options on Health Care Eligibility Renewal Notice MINNIE MOUSE MINNIE MOUSE Page 8 of 29

9 Example of Information Summary in Health Care Renewal Eligibility Renewal Notice MINNIE MOUSE MINNIE MOUSE MINNIE MOUSE MICKEYMOUSE Page 9 of 29

10 Health Care Renewal Notice Who gets this notice? This notice is mailed to consumers whose QHP eligibility cannot be auto-renewed because they are projected to be eligible for Medical Assistance or MinnesotaCare as a result of the updated federal poverty levels for the coverage year. This notice will be viewable in the consumer's online account. The notice will list the effective date, the action of "Need to Renew" and the current coverage type of "Unknown." What does the consumer need to do? Consumers will need to complete, sign and send the included renewal form to the Department of Human Services (DHS), within 30 days, otherwise their eligibility will end on 12/31/17. Information should be mailed to the address indicated on the notice. The applicant must write in any changes to this information on the Heath Care Renewal Notice, or may include an additional piece of paper attached with the information specified. Be sure the consumer reads all the legal notifications and agreements on this form. The consumer MUST sign the form, or it will not be processed. They can send a copy of the signed form or the original. The form should be mailed to the address indicated on the notice. Verification documents can be included when submitting the renewal form. The last page of the Health Care Renewal Notice has information for consumers with questions. The renewal forms are processed by the Department of Human Services (DHS). Consumers receiving the Health Care Renewal Notice must contact the MHCP Member Help Desk with questions about the notice and their renewal status. What happens next? If the consumer does not respond within 30 days, the consumer will be enrolled for 2018 without financial assistance. The eligibility determination will end 12/31/2017 and the consumer will need to reapply to re-determine eligibility. If the consumer responds, DHS will follow through to determine eligibility and will send the Health Care Notice with the results. Page 10 of 29

11 MOUSE MICKEY Health Care Renewal Notice-Renewal Form Page 11 of 29

12 Health Care Renewal Form Agreements Page 12 of 29

13 Health Care Renewal form Questions Page 13 of 29

14 Health Care Notice (System generated manual renewal eligibility notice) Some consumer's QHP eligibility did not auto-renew. These cases require follow-up by MNsure or DHS and in some cases, documentation from the consumer. Once the follow-up is completed this notice will generate. This notice will be mailed out to consumers and be viewable in the consumer's online account. Who will receive this notice? Consumers whose QHP eligibility did not auto-renew or are not eligible for assisted QHP coverage for 2018 due to a change in eligibility (i.e., public program eligible, etc.). Consumers in this category may have received the MNTR notifying them that they may be eligible for MinnesotaCare or Medical Assistance. After they return the information requested to DHS, DHS will send this notice with the new eligibility. Consumers who are newly eligible for QHP based on updated eligibility. o Consumers can log into their MNsure.org account starting November 1, if they would like to select a plan for next year using their updated eligibility Consumers who remain QHP eligible with updated 2018 eligibility. o If they are currently enrolled, they can remain in the same plan if available and MNsure will update their tax credit amount for 2018, if applicable. o They can log into their MNsure.org account if they want to select a different plan for 2018 using their updated eligibility. o If they are not currently enrolled they can log into their MNsure.org account and select a plan What happens next? Based on the updated eligibility the consumer could: Be eligible for MinnesotaCare or Medical Assistance and receive information from DHS Be eligible for QHP and currently enrolled in a plan for 2017 o They can enroll in a new plan during OE o They can do nothing and remain in the same plan with updated tax credits if applicable Be eligible for QHP and not currently enrolled in a plan o They can enroll in a new plan during OE. Page 14 of 29

15 Health Care Notice will show eligibility determination 1/1/2018 Approved Qualified Health Plan with Advanced Premium Tax Cost Sharing Reductions Page 15 of 29

16 Instructions for the consumer on the Health Care Notice Page 16 of 29

17 Enrolled but No 2018 Eligibility Renewal Notice Who will receive this notice? If consumers are currently enrolled in a health insurance plan through MNsure and do not have Insurance Assisted (IA) or (unassisted QHP) UQHP eligibility for 2018, they will receive this notice in the mail (with the exception of consumers who will receive the Health Care Renewal notice, or Need to Renew consumers since they follow a separate renewals process and will receive different notices). A household will only receive this notice if none of the QHP enrollees in a household have IA or UQHP eligibility in METS for 2018 What does the consumer need to do? Consumers can apply online during open enrollment to receive a 2018 eligibility determination. If they apply and are determined eligible to purchase a QHP, they can shop for a plan and enroll online through their MNsure account. What happens next? If consumers apply during open enrollment, based on their updated eligibility, they could: Be eligible for MinnesotaCare of Medical Assistance and receive information from DHS Be eligible to purchase a QHP. If they are currently enrolled and they wish to keep their plan, they can select their same plan for 2018 if available and have their updated subsidy amount applied, if applicable. If they are currently enrolled and they want to change plans, they can select a plan for 2018 and have their updated subsidy amount applied, if applicable. If they are not currently enrolled and they wish to enroll, they can select a plan for 2018 and have their subsidy amount applied, if applicable. What happens if the consumer does nothing? If the consumer does not apply, their current QHP enrollment will be renewed for 2018 but any financial assistance they are currently receiving will end December 31, If they want financial assistance for 2018, they must apply online during open enrollment so we can determine what help they qualify for. Page 17 of 29

18 Examples of information in the Enrolled but No 2018 Eligibility Notice Page 18 of 29

19 Page 19 of 29 Renewals Guide for Assisters: Open Enrollment 2018

20 Page 20 of 29 Renewals Guide for Assisters: Open Enrollment 2018

21 Health Care Notice (System generated SEN) Consumers receive this notice when they apply online during Open Enrollment (OE) or report a change during OE after their case has been auto-renewed. This standard eligibility notice (SEN) for OE will include their household's eligibility results (for public and private programs) and dates for OE plan selection. The notice will be mailed out to consumers and will be viewable in the consumer's online account. Page 21 of 29

22 Health Care Notice for QHP eligibility Page 22 of 29

23 Health Care Notice Verification Request Page 23 of 29

24 Plan Enrollment Notice (Confirmation) This notice is sent to individuals who are enrolled in a QHP through MNsure. The notice confirms what plan the household will be enrolled in for If a consumer subsequently reports changes that make them no longer eligible for QHP, the 2018 QHP enrollment will be canceled. The notice lists the plan name, the premium and the APTC if applicable. If the consumer made more than one plan selection for the same coverage effective date, the last plan selected is considered the enrollment choice. Page 24 of 29

25 Page 25 of 29 Renewals Guide for Assisters: Open Enrollment 2018

26 Page 26 of 29 Renewals Guide for Assisters: Open Enrollment 2018

27 Assister Tips The following tips are for help when you are assisting consumers: Consumers must respond to the Health Care Eligibility Renewal notice before the listed deadline to ensure they have an accurate eligibility determination for They should respond as soon as possible to ensure timely updates to their eligibility. Activate your access to the assister portal so that you can become familiar with it and help enrollees complete the renewal process as efficient as possible. Help consumers learn about plan options before they can shop during open enrollment, so they can make sure they find the best plan for their household. If a consumer has changes to report, make sure they have the correct supporting documentation. Notices sent out can become outdated if there is a change after a notice is processed. Be sure consumers are referring to the notice with the most current date if they have more than one. Consumers that change plans by shopping during open enrollment may want to contact their carrier to stop any automatic billing. MNsure does this as well, but depending on the timing, it may not be stopped right away. Some notices will be viewable under the "My Notifications" menu in a consumer's account, or under the eligibility section. Page 27 of 29

28 Page 28 of 29 Renewals Guide for Assisters: Open Enrollment 2018

29 Resources 1. Renewal FAQ page on MNsure.org 2. Reporting Changes page on MNsure.org Page 29 of 29