Welcome to the Agent and Broker Video Learning Center.
In this video, we’re going to do a walkthrough of the offers of employer sponsored coverage section of the
streamlined HealthCare.gov application.
A household member applying for Marketplace coverage is seeking savings to reduce the cost of their coverage
and they are offered health coverage from their employer.
We’ll also highlight new application features.
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 scenario features Susan and Robert, a married couple living together in Texas,
applying for Marketplace coverage and seeking savings to reduce the cost of their coverage.
Susan is applying on behalf of the household, and started working fulltime for her employer
a few months ago, and is now eligible to enroll in her employer’s health coverage.
Susan and Robert may be able to receive savings through the Marketplace,
such as advance payments of the premium tax credit, based on the information they entered up to this point,
so they’ll answer a few more questions to help determine if they’re eligible for savings.
Since Susan and Robert said they aren’t currently enrolled in health coverage from any employers,
they’ll be asked if they’ll be offered health coverage from an employer on November 1,
the first day of the upcoming month, as they are applying on October 10, 2019.
Susan will in fact have an offer of coverage from an employer on November 1,
so she’ll select her name and continue in the application.
Robert isn’t offered coverage through his job or Susan’s job, so Susan won’t select his name.
If Susan needs more information on who to select as having an offer of coverage,
she can select the link to learn more.
The names of all employers added to the application when the household members entered their income
information will automatically populate on this page.
In this case, Susan is able to select that either her employer, Robert’s employer, both of their employers,
or another employer will offer Susan health coverage.
Susan’s employer will offer her health coverage on November 1,
so she’ll select her employer’s name and continue.
Susan isn’t offered coverage through Robert’s job, so she won’t select his employer’s name.
Next, Susan will be asked if her employer is offering a health plan that meets the minimum value standard.
If Susan needs help completing this section of the application, she can select this link to go the
Marketplace Employer Coverage Tool.
Susan can ask her employer to help her fill out this tool,
and then use the information she collected to continue the application.
She can also review materials provided by her employer on her health coverage offer,
or ask her employer directly, to help determine if the health plan meets the minimum value standard.
In this scenario, Susan already discussed the offer of health coverage with her employer and knows
the employer is offering a health plan that meets the minimum value standard, so she will select “Yes”.
Next, Susan will enter the premium amount she would pay if she accepted this coverage from her employer.
This premium amount is the lowest amount she would pay for a plan that meets the minimum value standard
if she was the only one enrolled in this coverage, regardless of whether her husband, Robert, is also able
to receive this coverage.
When Susan talked to her employer, she confirmed that the premium to cover only herself is $200 a month.
She’ll enter this information in the application and continue.
Finally, Susan will enter the contact information of the person at her job who manages employee benefits.
She enters the phone number, email address, name, and address of this person at her job.
If Susan needs help determining which person’s contact information to provide,
she can select the link to learn more.
After entering this information, Susan will continue to the next section of the application.
This next scenario features Susan and Robert, a married couple living together in Texas,
applying for Marketplace coverage and seeking savings to reduce the cost of their coverage.
Susan is applying on behalf of the household and she started working fulltime at her employer two months ago
and is now eligible for coverage.
Robert works for a small employer that started offering its employees’ health insurance for the first-time
last month.
Neither of them have enrolled in their employer’s plan.
Susan and Robert may be able to receive savings through the Marketplace, such as
advance payments of the premium tax credit, based on the information they entered up to this point,
so they’ll answer a few questions to help determine if they are eligible for savings.
Since Susan and Robert said they aren’t currently enrolled in health coverage from any employers,
they’ll be asked if they’ll be offered health coverage from any employer on November 1, the first day of the
upcoming month.
Susan and Robert will have an offer of health coverage from each of their employers on October 1,
so she will select both her and Robert’s names and continue the application.
Any employers added earlier to the application when Susan entered her and Robert’s income information will
automatically populate on this screen.
For this scenario, Susan could select that her employer, Robert’s employer, both their employers,
or another employer will offer Susan or Robert health coverage.
Susan could get coverage through either her employer or Robert’s employer on November 1,
so she’ll select both employers and continue.
Similar to Susan, Robert will have offers of coverage from both his employer and Susan’s employer on
November 1,
so Susan will indicate such and continue.
Next, Susan will be asked if all employers are offering a health plan that meets the minimum value standard.
If Susan needs help completing this section of the application,
she can click this link to go the Marketplace Employer Coverage Tool.
Susan can ask her employer to help her fill out this tool, and then use the information she collected
to continue the application.
Additionally, if Susan wants to learn more about the minimum value standard,
she can click this help text.
She and Robert can also review materials provided by both their employers on their health coverage offers,
or ask their employers directly, to help determine if the health plans meet the minimum value standard.
In this scenario, Susan and Robert already discussed the offer of health coverage with their employers
and know both employers are offering a health plan that meets the minimum value standard,
so she will select that both employer health plans meet this.
Next, Susan will enter the premium amount she would pay if she accepted the coverage offer
from her employer.
This premium amount is the amount she would pay if she was the only one enrolled in this coverage,
regardless of whether her husband, Robert, is also able to receive this coverage.
When Susan talked to her employer, she confirmed that the premium to cover only herself is $200 a month.
She’ll enter this information in the application and enter Robert’s information.
Susan will enter the premium amount Robert would pay if he accepted the coverage offer from his employer.
This premium amount is the amount he would pay if he was the only one enrolled in this coverage,
regardless of whether his wife, Susan, is also able to receive this coverage.
When Robert talked to his employer, he confirmed the premium to cover only himself is $300 a month.
Susan will enter this information from Robert in the application and continue.
Finally, Susan will enter the contact information, including phone number, email address, first name,
and last name of the contact person at each employer that offers coverage.
She’ll first enter her employer’s contact information
… and then enter the contact information for Robert’s employer.
If Susan needs help determining which person’s contact information to provide,
she can select the link to learn more.
After entering this information for both employers,
Susan will continue to the next section of the application.
We hope this video has been helpful. If you haven’t already,
we encourage you to watch our other videos for a full walkthrough of the
streamlined HealthCare.gov application.
If a consumer needs additional support answering questions related to employer sponsored coverage,
they should contact the Marketplace Call Center.