plan compare walk-through: comparing and selecting plans
TRANSCRIPT
Plan Compare Walk-through: Comparing and Selecting Plans
9/22/2017
2
Agenda
• Plan Compare Overview • Choosing APTC • Enrolling Family Members in Different
Plans • Plan Selection • Question and Answer Session
3
Plan Compare Overview
• Plans display based on information submitted on the eligibility application, including
– Rating area (zip code & county)
– Number of family members seeking coverage
– Family members’ ages and tobacco status
• Browse plans before applying at https://www.healthcare.gov/see-plans/
• Only qualified health plans are displayed
4
Plan Compare Flow
Create Account (Including ID
Proofing)
Complete and Submit Application Eligibility Results
Enrollee To-do List/Plan Compare Questions (Set APTC, Answer Household Questions,
Set Enrollment Groups)
Compare Health Plans
Select Health Plans
(for Everyone Seeking Coverage on the Application)
Separate Dental Plan Desired?
Select Dental (Optional)
– Attest to APTC Policy
– Confirm Plans
Pay Online or
Pay Issuer Invoice
Enrolled!
5
Plan Compare Scenario
• Andre is applying for coverage and financial assistance for himself and his wife Bridget
• Eligible to enroll in a Qualified Health Plan through the Marketplace
• Eligible for up to $414/month in payments of the Advance Premium Tax Credit (APTC)
6
Plan Compare Navigation: To-Do List
7
Set APTC Amount Used for Premium Discount
8
Instruct Applicants on APTC
9
Set APTC Amount: Does consumer want to use all $414 for premium discount?
10
APTC Amount Text Box
11
Confirm APTC Amount
12
Use None of the Tax Credit
13
Household Questions
14
Tobacco Usage
15
Step 3: See if Plans Cover Your Doctors, Hospitals, and Prescription Drugs
16
Step 4: Level of Medical Care for the Year
17
Step 4: Level of Medical Care for the Year
18
Step 4: Level of Medical Care for the Year
19
Step 4: Level of Medical Care for the Year
20
Selecting a Plan
21
Enrolling Family Members into Different Plans
Can a family apply all together on an application and enroll in separate plans?
Yes, the family can apply together and be determined eligible
for a Qualified Health Plan. Once determined eligible, the family can take the steps below to select a different plan for different family members (or groups of family members).
APTC is allocated to each plan not by the applicants but by a business rule described in 155.340(f) (although the
application filer can decide how much of the family’s maximum APTC is applied each month, as discussed above).
22
Enrollment Grouping
23
Enrollment Grouping
24
Before Seeing Plan Results, Consumer is Shown Icons to Compare Plans
25
Overview of Plans: The “Metal Table” summarizes plans by metal level, displaying premium ranges and cost
sharing like deductibles and copayments
26
Overview of Plans: Simple Choice
27
Overview of Plans
28
Filters
29
Example Filter: Simple Choice
30
See All Plans
31
Selecting a Plan: Press “enroll” from results; side-by-side, or details view
32
Confirmation of Plan Selection
33
Dental Selection - Marketplace health plan required to purchase dental plan
- Separate dental is optional
34
Dental Selection (Optional) Note that this question highlights whether dental was included in the health plan
35
Dental Plan Details
36
Confirm Dental Plan Selection
37
Review and Confirm
38
APTC Attestation
• Applicant agrees to file a federal income tax return (file jointly with a spouse)
• Applicant agrees to no one else being able to claim him or her as a dependent
• Applicant would electronically sign and select “Finish Plan Selection”
39
Confirm Choice of Major Medical Health and Dental Plans
40
Plan Payment Page Green “Pay for Plan” button means online payment is available
• Making the first premium payment is the final step of enrollment
• Applicants must pay their first premium in order to maintain coverage
• After the applicant selects a plan he or she will either see a link to the insurance company’s website or instructions on how to pay their premium payments to their insurance company