Welcome to the Agent and Broker Video Learning Center.
This video will provide a walkthrough of the streamlined HealthCare.gov application,
wherein the household is NOT seeking savings to reduce the cost of their Marketplace coverage.
For a walkthrough of the application wherein the household is seeking financial assistance,
watch our other video “Streamlined Marketplace Application Walkthrough – Household Seeking
Financial Assistance” linked in the description below.
In this video, the term "Marketplace" refers to Federally-facilitated Marketplaces, or FFMs,
including FFMs where states perform plan management functions, and State-based
Marketplaces on the Federal Platform, or SBM-FPs. This walkthrough features Susan and Robert,
a married couple living together in Texas with their son James.
Susan and Robert are new to the Marketplace. Since they haven’t applied for Marketplace
coverage before, they’ll need to create an account on HealthCare.gov and verify their identity.
Susan is applying on behalf of the household, so she will indicate where they are seeking
coverage and for what plan year. Afterward, she will select the green “Apply or renew” button.
On the next page, Susan will see an overview of those for whom she can apply for coverage
and what information she may need to complete the application.
After reviewing the information on this page, she’ll select the green
“Next” button to proceed to complete identity proofing, which won’t be reviewed in this video.
Please note: When applicable, the application will pre-populate identity-proofing information in the application
such as the household contact's name, and date of birth.
After completing identity proofing, the next page will confirm that Susan’s identity has
been verified. It will also provide additional information on the Marketplace communications
she should expect to receive, and reviews the Marketplace’s privacy policy.
After Susan has reviewed this information, she’ll agree to the two attestations at the bottom
and select the green button to proceed to the application.
The next page will provide Susan with an overview of the four main sections
she will need to complete in her Marketplace application before receiving eligibility results.
Susan previously indicated that the household is seeking coverage in Texas,
which is reflected on this page. If she wants to change the application state, she would select
the “change your state” link to return to her Marketplace account and start a new application.
Susan will answer several guiding questions about her household.
As a reminder, Susan is applying for coverage for herself, her husband, and their son. She and
her husband file their taxes jointly each year and claim their son as a dependent,
so she will indicate that she reports three people on her tax return.
The next question will help Susan determine if she should seek savings to reduce the cost of
her family’s Marketplace coverage. Since Susan estimates she and her husband will
make more than $92,000 in 2022, she’ll select the “More than $92,000” option.. She and her
family may qualify for financial assistance but they do not wish to see if they qualify.
Susan will indicate that she wants to continue the application without checking for savings options
so she won’t be asked extra questions regarding eligibility for savings.
Then she’ll select the green “Continue” button. Next, Susan will enter more information about
herself. She’ll make sure “Yes” is selected for ”Do you need coverage for yourself?”,
confirm her legal name and date of birth, and select her sex.
To proceed throughout the application, Susan will select the green “Save & Continue” button.
Next, Susan will confirm the address in the state where she is applying for coverage.
Note, this address cannot be a PO Box.
If consumers live outside the state in which they’re applying for coverage,
they’ll need to answer a few more questions
to confirm coverage eligibility for the state in which they’re applying.
On the next page, Susan will confirm her address,
either selecting the USPS record, if provided, or her original entry.
Then, she’ll indicate if the address she entered is also her mailing address.
On the next page, Susan will confirm her contact information,
including her email address and phone number.
Susan’s preferred written and spoken language is English. English is automatically populated
on this page, but consumers can use the dropdowns to select a different language.
Next, Susan will confirm how she would like to receive notices about her application.
Notifications that new notices are in the account can be received via email or text, or notices can
be mailed. In this case, Susan prefers to get notifications for new notices by email.
Please note, if you choose to receive notices by mail,
your notices will still be available electronically in your online account.
On the next page, Susan can indicate if a professional or professionals are helping
her complete her application. There are four types of professionals to choose from and Susan
can learn more about each by clicking “Learn about professionals who may help with your application.”
If Susan is working with a navigator, she will enter that person’s name.
Professionals can assist consumers in completing this section.
Susan will enter similar information if she is working with a certified application counselor…
… or if she is working with another type of assister.
In this scenario, Susan is actually working with a Broker.
She’ll enter the broker’s name and their National Producer Number, or NPN.
On the next page, Susan will add additional people who need coverage,
including her husband and son, by selecting the “Add a person who needs coverage” button.
For more information on how to complete this portion of the application,
or for more complex household scenarios, watch our other video.
Susan will enter Robert’s first and last name and date of birth,
select his sex, and then indicate his relationship to her. Robert is Susan’s spouse, but applicants
have many different relationship options to choose from, depending on their situation.
Susan will select the “Add a person who needs coverage” button again, enter her son, James’s,
information and then indicate his relationship to both her and Robert as their child.
Before proceeding, Susan should confirm she,
her husband, and their son are listed as seeking coverage.
If Susan wants to learn more about removing members from this list, she can select the
“Learn more” link to see more information to help her complete the section properly.
Be sure to utilize these links throughout the application process.
Applicant statuses can be easily changed to indicate they are not seeking coverage.
Additionally, applicants can remove other household members from the current version
of the application due to a divorce, death, or another reason. To do so, Susan would select
“Remove” next to the name of the family member she wishes to remove from the list.
In this case, everyone listed will remain on the application and Susan will continue.
For more information on how to remove existing household members from the current application,
watch our other video.
On the next two pages, Susan will confirm that she, Robert,
and James live together at the address she entered earlier in the application.
Next, Susan will be asked if any of the situations listed apply to any of the people
in her household. None of them did, so she’ll indicate such and continue in the application.
Next, Susan has the option to enter more information about herself.
She can indicate if she is of Hispanic, Latino, or Spanish origin, and her race.
Selecting Susan’s race and ethnicity will help the U.S. Department of Health and
Human Services improve service to all people using the Marketplace,
and, if entered, doesn’t impact Susan’s eligibility for coverage, plan options, or costs.
For more information on how to complete this portion of the application, watch our other video.
Susan will answer the same questions for both Robert and James.
Next, Susan will enter her Social Security Number and confirm her name
matches what is on her Social Security card. She’ll do the same for both Robert and James.
Social Security Numbers should be entered to verify information that the Marketplace has access
to through other federal agencies. If someone doesn’t have a Social Security Number, or a Social
Security Number isn’t entered, they may need to submit documents later to verify information.
Next, Susan will confirm that every person applying for coverage is a U.S. citizen
or U.S. national. For more information on how to complete this portion of
the application for more complex scenarios, watch our other video.
Before answering questions about life events and coverage changes,
Susan will review information about coverage changes that may affect her coverage options.
Susan and Robert are not offered an individual coverage health reimbursement arrangement
or provided a Qualified Small Employer Health Reimbursement Arrangement,
also known as a QSEHRA, starting within 60 days of today, so she’ll select “None of these people.”
For more information on health reimbursement arrangements, or HRAs, watch our other video.
However, Susan used to have coverage through her employer, but they recently stopped
offering it. Since Susan recently lost qualifying health coverage,
she’ll enter the date on which she lost coverage before continuing.
Next, no one in Susan’s family will lose qualifying health coverage within the next
60 days, so she will select “None of these people” and continue in the application.
Next, neither Susan nor Robert recently experienced any other life changes,
like moving. If they had, they would enter information on the recent life change.
Providing information on recent coverage changes or any of these life changes
may qualify applicants for a special enrollment period.
They may need to submit documents later to confirm this information.
This next page will display all information Susan entered in the application.
Susan will review the information to confirm it’s correct. If she needs to make edits,
she can select any of the “Edit” buttons next to the specific information.
Next, Susan will review and respond to several statements.
Afterward, she’ll sign and submit her Marketplace application and get her eligibility notice.
Based on the information entered in the application, Susan, Robert,
and their son, James, are eligible to enroll in a qualified health plan from the Marketplace.
Since Susan chose not to apply for savings to reduce the cost of coverage,
the Marketplace didn’t determine her family’s eligibility for advance payments of the premium tax credits,
or the Medicaid and CHIP programs. Because Susan said she recently lost qualifying health coverage,
she and her family are eligible for a Special Enrollment Period.
This allows them to enroll in a Marketplace health plan even outside the open enrollment period.
The red text that appears on this page indicates the consumer needs to submit documents
to confirm their loss of coverage before they can enroll in coverage.
To continue with her enrollment, Susan must view her eligibility notice,
which contains the complete information on her household’s eligibility.
This notice also contains information on documents that may be submitted to resolve any open issues,
including confirming Susan’s recent loss of coverage through her employer.
After Susan has reviewed her eligibility notice, she will select the “Continue to
Enrollment” button since she and her household are eligible for a Special Enrollment Period,
pending document submission. The Special Enrollment Period will allow Susan and
Robert to enroll in a Marketplace health plan outside the open enrollment period.
Next, Susan will use the Plan Compare tool to select a qualified health plan and, if she wants
one, a dental plan. She will be guided through tobacco usage reporting, enrollment grouping,
plan comparison, plan selection, and confirmation of enrollment.
We hope this video has been helpful. If a consumer needs support completing
a Marketplace enrollment application, they should contact the Marketplace Call Center.