WebEx Training

Friday, February 7, 2014

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Agenda

Fast Alert - Medicaid

Fast Alert - Complete Addresses & Names on Mailboxes

Fast Alert - Dis-enrolling/Re-enrolling

Fast Alert - Questions Regarding Premiums & Reimbursement

Fast Alert - Verification Notices

Fast Alert - Anthem Coverage Advertisement

Fast Alert - Call Center Brokers’ Hours of Operation

Medicaid Applications

Medicaid Spend Down

If a consumer is currently on HUSKY (Medicaid) do they need to apply through the marketplace if their health coverage has not yet ended?

• Consumers currently on HUSKY (Medicaid) will receive an eligibility redetermination letter from DSS when their HUSKY eligibility needs to be redetermined.

• The individual is eligible to apply up to 60 days prior to their Spend Down end date.

• Consumers must re-apply through one of several ways. They may apply through the Access Health CT website; at an enrollment Center, with a certified application counselor; or with an in-person assister or navigator .

Medicaid (Fast Alert 1/28/2014)

Topic

• Please remember to include the applicant’s full address on all Marketplace applications including building and apartment number.

• Leaving a building or apartment number blank on an application could potentially cause challenges when the United States Postal Services delivers mail.

• Be aware that any applicant that does not have their name on their home mailbox will not receive mail from DSS.

Complete Addresses & Names on Mailboxes (Fast Alert 1/28)

Topic

Is there ever a situation where a consumer should dis-enroll and then re-enroll in the same program?

• A consumer should not dis-enroll and later try to reenroll in the same program. This applies for both QHP‘s and Medicaid. If there is a legitimate change to be reported, the change should be reported through the call center or AHCT website.

• If a consumer wishes to explore other plan information, he/she may access Anonymous Browsing.

• It is not wise to dis-enroll and then later re-enroll to make a change. This action could lead to gaps in coverage and incorrect portal results as the system may pick up a prior enrollment status.

Dis-enrolling/ Re-enrolling (Fast Alert 1/28)

Topic

All inquiries regarding an enrolled consumer’s premiums and

payment must be directed to the carrier.

If a consumer wants their premium to be reimbursed, the Call Center representative will direct them to their carrier.  Only carriers can make decisions regarding the reimbursement of a member’s premium. 

Call center representatives will inform consumers that if they are

not satisfied with the carrier decision on a premium reimbursement,

they can file a complaint with The Connecticut Insurance Dept.

Questions Regarding Premiums & Reimbursement -- Fast Alert (2/4)

Topic

Be aware that on 2/5/14 notices were sent to those consumers who had not yet submitted all of their required verification documents.

When consumers call about these notices, Call Center Representatives must inform them that they will have 30 days to send in any remaining documentation, if they have not done so already.

Fast Alert (2/4 ) Verification Notices

Topic

Anthem Blue Cross/Blue Shield has run a print advertisement

stating that if a consumer paid his or her premium by 1/31/14,

coverage would be effective as of 1/1/14.

This advertisement was referring only to those who had enrolled

prior to the 15th of January, but had not yet paid their premium for

January.

Anthem Coverage Advertisement -- Fast Alert (2/4)

Topic

The hours of operation for Call Center brokers are Monday to

Friday from 9:00AM to 5:30PM. For consumers needing

assistance from a Call Center broker before 9:00 AM and after

5:30 PM, a call center representative will create a Broker Callback

Request. A broker will get back to the caller as soon as possible.

Call Center Brokers’ Hours of Operation -- Fast Alert (2/4)

Topic

Access Health CT is receiving a number of Medicaid applications

where the applicant stops at the Eligibility determination screen

in the portal and does not click the Submit button.

Reminder: In order for the application to be submitted to DSS,

the applicant needs to click Submit.

Medicaid Applications

Topic

Are there some Spend-Downs still going on and how long will they be extended for?

• There will be no new Spend Down programs as of 1/1/2014 for single adults. Single adults are the biggest expansion group affected by the ACA so no new Spend Down will begin as of 1/1/14.

• Spend Down programs will continue for 2 other types of plans - Families will continue and Elderly/Disabled (traditional Medicaid) will also continue.

Medicaid Spend Down (submitted to NIPA mailbox)

Topic

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