Reform Alert - News from the Blues' Office of National Health Reform

CCIIO issues guide to assist agents and brokers through the Marketplace enrollment process

Dec. 20, 2013

On Dec. 2, the Center for Consumer Information & Insurance Oversight (CCIIO) issued a “Tips for Agents and Brokers” guide to help them when assisting consumers in completing Marketplace applications.

The step-by-step guide was created for agents and brokers to follow when assisting consumers through the enrollment process. The document provides instructions on using both direct and Marketplace enrollment.

The guide advises agents that if the Federally-Facilitated Marketplace (FFM) is not available, the agent or broker can arrange a three-way call between the agent, the consumer, and the Marketplace Call Center (1-800-318-2596) to fill out the application over the phone, receive an eligibility determination and choose a plan. The consumer must be on the phone with the agent or broker and Call Center representative to complete an application and/or make a plan selection. The Call Center will record the agent’s information when the agent and consumer conduct a three-way call with the Call Center.

The guide also recommends that if an individual becomes stuck in the application process, he or she should remove the ongoing application by logging into his or her account and then clicking “Remove” in the My Account section. The applicant should then close out the web page and log back in using his or her same account. The agent/broker can then assist with starting a new application.

Furthermore, the guide recommends that if the individual has submitted a paper application but has received no response within about a week, the agent and consumer should call the Call Center. The center can look up whether or not the applicant has an eligibility determination in the system and can provide his or her application ID#1. The individual can then continue with the Call Center, visit the Marketplace website, or utilize direct enrollment.

1 If the call center cannot pull up the client’s eligibility determination and application ID, the client should begin the process over by creating a new Marketplace account.

Where can I find more information?

More information can be found in the Tips for Agents and Brokers document.

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.