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Page: 1 of 5: Welcome to the What’s New for Returning Agents and Brokers Module

Long Description Animated introduction screen containing the following text at the top and left of the screen: Welcome to the What's New for Returning Agents and Brokers Module. Beneath this text on the left is the logo for the Department of Health & Human Services (HHS), which is made up of the profiles of people, stacked on top of each other, resulting in the profile of an eagle. The words "Department of Health & Human Services USA" form a circle that extends out and to the left from the profiles. To the right of the logo are the words “Health Insurance Marketplace®.” On the right side of the screen are three images from the module representing agents and brokers and module-specific concepts.

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Page: 2 of 5: Disclaimer

Page Text The information in this training was current at the time it was published or uploaded onto the Web. Eligibility policies and Marketplace requirements may change so links to the source documents have been provided within the document for your reference. This training is not intended to grant rights or impose obligations. It may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage learners to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of the requirements. This communication was printed, published, or produced and disseminated at U.S. taxpayer expense. Alt Text A page of text box with horizontal lines across it; a red horizontal box containing the word "Disclaimer" within it

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Page: 3 of 5: Introduction

Page Text Welcome to the What’s New for Returning Agents and Brokers training. This training will tell you about new policy or process changes that have occurred (or are planned to occur) for the Health Insurance Marketplace®* for plan year 2021 and should take you about 30 minutes to complete. During this What's New Training, you will: • Learn about updates to the regulations for implementing the Patient Protection and Affordable Care Act (Affordable Care

Act) and other guidance that impacts Marketplace operations for plan year 2021 • Learn more about the requirements for agents and brokers who assist consumers referred by Help On Demand • Review the Marketplace requirements that agents and brokers must comply with when assisting consumers in the

Marketplace • Review the dates for the plan year 2021 Open Enrollment period and learn about new options for filing an appeal of an

eligibility determination • Identify new guidelines that impact consumer eligibility for insurance affordability programs and how to help clients

integrate an individual coverage Health Reimbursement Arrangement (HRA) with advance payments of the premium tax credit (APTC) for Marketplace coverage

• Learn about new capabilities for the Enhanced Direct Enrollment Pathway • Recognize new policies that impact consumers who are eligible for retroactive coverage, consumers who are newly

enrolling in Marketplace coverage with household members who are already enrolled, and consumers who newly gain access to an individual coverage HRA or Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

• Review how consumers should record your National Producer Number (NPN) on Marketplace applications • Review the terms and conditions for accessing Centers for Medicare & Medicaid Services (CMS) systems when assisting

consumers with enrollments in Marketplace plans

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In addition, the training will identify key resources where you can find information about working in the Marketplace and get technical assistance with questions or issues. *The term "Health Insurance Marketplace®" is a registered trademark of the U.S. Department of Health & Human Services (HHS). When used in this document, the term “Health Insurance Marketplace®” or “Marketplace” refers to Federally-facilitated Marketplaces (FFMs), including FFMs where states perform plan management functions, and also refers to State-based Marketplaces on the Federal Platform (SBM-FPs).

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Page: 4 of 5: Structure and Navigation

Page Text This training contains a bookmarking feature that allows you to stop at any point and return later to continue where you left off. To successfully complete this training for returning agents and brokers, you must review each of the following topics:

1. Welcome 2. What's New for Affordable Care Act and Marketplace Basics 3. What's New for the Individual Marketplace 4. What's New for Marketplace Privacy and Security 5. Summary of Key Resources

Training Navigation:

• Selecting Back takes you to the previous page. • Selecting Next takes you to the next page. • Selecting Menu takes you to the menu page and provides access to any of the topics. • Selecting Help displays information about accessibility and functionality. • Selecting Glossary displays a list of terms and acronyms used. • Selecting Exit closes the training.

Alt Text A blue compass

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Page: 5 of 5: Topic Completion

Page Text You have completed the Welcome to the What’s New for Returning Agents and Brokers Training topic. Return to the Menu and proceed to the What's New for Affordable Care Act and Marketplace Basics topic. Alt Text An animated figure sitting on top of a square with a green check mark in the center; the animated figure is giving a thumbs-up.

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Topic: 2 of 5: What’s New for Affordable Care Act and Marketplace Basics Page: 1 of 4: Annual Cost Sharing Limits for 2021

Page Text Annual cost-sharing limits cannot exceed specified amounts.* For 2021, the maximum annual out-of-pocket limitation on cost sharing has increased to $8,550 for an individual and $17,100 for families enrolled in individual or group market plans. *Beginning with plan year 2021, when consistent with state law, the issuer or plan may, but is not required to, count direct support offered by drug manufacturers for specific prescription drugs towards the consumer’s annual cost-sharing limit. Alt Text Bar graph with two bars from left to right; Details and information about the bars from left to right are: blue bar, labeled “Single', $8,550, individual person image; light blue bar, tallest, labeled “Family” $17,100, family image.

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Page: 2 of 4: Reminder: Help On Demand

Page Text Help On Demand is a real-time consumer assistance referral system that connects consumers seeking assistance with Marketplace-registered, state-licensed agents and brokers in their area who can provide immediate assistance with Marketplace plans and enrollments. Only agents and brokers who have completed Marketplace training and registration for the applicable plan year and have an active state license that is approved for a health-related line of authority by the state(s) where they plan to sell Marketplace coverage are eligible to participate in Help On Demand. Agents and brokers are required to assist consumers with submitting Marketplace applications and enrollments. Also, if consumers are eligible for state Medicaid or CHIP programs, agents and brokers are expected to help these consumers connect with the appropriate state agency to apply for this coverage. To participate in Help On Demand, agents and brokers must first complete Individual Marketplace registration and training and sign privacy and security agreements. Agents and brokers may then complete Help On Demand-specific coursework on the Marketplace Learning Management System (MLMS), only available after signing CMS agreements at http://portal.cms.gov. For more information on the Help On Demand system, see this overview. Alt Text Screenshot of Get Contacted with a Help From Agent/Broker button

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Page: 3 of 4: Reminder: Compliance with Marketplace Requirements

Page Text The standards of conduct for agents, brokers, and web-brokers who participate in the Marketplace have not changed for plan year 2021. These standards include requirements to:* • Provide consumers with correct information, without omission of material fact, regarding the Marketplace, QHPs offered

through the Marketplace, and insurance affordability programs; • Refrain from marketing or conduct that is misleading (including by having a direct enrollment website that HHS determines

could mislead a consumer into believing he or she is visiting HealthCare.gov); coercive; or discriminates based on race, color, national origin, disability, age, sex, gender identity, or sexual orientation;

• Provide the Marketplace with correct information under section 1411(b) of the Affordable Care Act; and • Obtain the consent of the individual, employer, or employee prior to conducting an online person search, assisting with or

facilitating enrollment through the Marketplace, assisting the individual in applying for APTC and cost-sharing reductions (CSRs), and making updates to a consumer’s eligibility application or subsequent plan selection and enrollment.

For more information, please review Compliance with Marketplace Requirements: Updates and Reminders for Agents and Brokers.

*See 45 C.F.R. § 155.220(j) for the complete list of standards of conduct.

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Alt Text Compliance concept with icons, virtual screen, businessman touching button.

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Page: 4 of 4: Topic Completion

Page Text You have completed What’s New for Affordable Care Act and Marketplace Basics. You are encouraged, but not required, to complete the optional Basics Review for Returning Agents and Brokers, which reviews selected health care reforms and consumer protections required under the Affordable Care Act, and the key roles and responsibilities of agents, brokers, and web-brokers who participate in the Marketplace. Return to the Menu and proceed to What’s New for the Individual Marketplace. Alt Text An animated figure sitting on top of a square with a green check mark in the center; the animated figure is giving a thumbs-up.

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Topic: 3 of 5: What's New for the Individual Marketplace Page: 1 of 14: Open Enrollment Period for Plan Year 2021

Page Text The Open Enrollment period for plan year 2021 is November 1, 2020 through December 15, 2020. Consumers must complete their plan selections by December 15 in order for their health coverage to become effective January 1. There are no opportunities to make an Open Enrollment plan selection after December 15, 2020. Select the Job Aids button for a printable version of key dates and the enrollment deadline for the Open Enrollment period. Alt Text Calendar image showing Open Enrollment dates highlighted

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Page: 2 of 14: Marketplace, Medicaid, CHIP, and “Public Charge” Status

Page Text On February 24, 2020, new U.S. Citizenship and Immigration Services (USCIS) regulations apply to the definition and factors for “public charge” status. These regulations outline how USCIS will determine whether applications for admission to the United States or applications for adjustment to immigration status will be denied because the applicant is likely at any time to become a public charge. Use of public benefits could be considered a negative factor in a public charge inadmissibility determination. This means it could affect a consumer’s chances of admission or adjustment of status. • Enrollment in a Marketplace plan (with or without the premium tax credit) is not a public benefit under the public charge

final rule. • For children under age 21 and pregnant women, enrollment in Medicaid or CHIP will not be considered to be a public

benefit under the public charge rule. However, for some foreign national adults, enrollment in Medicaid may be considered a negative factor in a public charge inadmissibility determination. If you are assisting a consumer who may be impacted by these regulations, the consumer should visit the USCIS website or contact USCIS directly before continuing his or her Marketplace application. For more information on what it means to be a public charge, visit USCIS’s website or call U.S. Citizenship and Immigration Services at 1-800-375-5283.

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Alt Text Regulations Compliance Rules Law Standard Business Concept; Businessman offers regulation text icon on virtual screen.

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Page: 3 of 14: New Options for Filing an Appeal of an Eligibility Determination

Page Text In addition to mail, consumers can now file an appeal of a Marketplace eligibility determination online or by fax.

• (New!) Online: Visit HealthCare.gov/marketplace-appeals/appeal-forms and select the applicable state. Submit the appeal request online or download and print the request form and submit it separately.

• Mail: Consumers should send a completed paper form or a letter requesting an appeal. Consumers should include their name, address, and the reason for the appeal. Mail the paper form or the letter to the Marketplace at: Health Insurance Marketplace ATTN: Appeals 465 Industrial Blvd London, KY 40750-0061

• (New!) Fax: Consumers can fax the paper form or letter requesting an appeal to 1-877-369-0130. Appeal requests must be submitted within 90 days of the contested Eligibility Determination Notice, unless the consumer demonstrates that his or her failure to submit the appeal on a timely basis was due to exceptional circumstances and should not preclude the appeal. Tip: The consumer should keep originals and mail only copies of all documents submitted during the appeals process. Alt Text Document, folder with stamp and text.

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Page: 4 of 14: Updates to Federal Poverty Guidelines

Page Text For the Open Enrollment period for plan year 2021, the Marketplace will make determinations of eligibility for APTC and income-based CSRs based on the 2020 HHS Federal Poverty Guidelines (often referred to as the "federal poverty level" [FPL]). Click here to view more information about the 2020 Federal Poverty Guidelines Chart. Select the Job Aids button for a printable version of the 2019 Federal Poverty Guidelines Chart. 2020 Federal Poverty Guidelines Chart Popup Box The Health Insurance Marketplace® will use the 2020 FPL guidelines when making calculations for APTC and income-based CSRs for coverage year 2021 starting November 1, 2020. Note that Medicaid and CHIP assessments/determinations are currently based on the 2020 FPL from the HHS 2020 Poverty Guidelines until January or February 2021 when HHS releases the new guidelines for 2021.

The 2021 guidelines have not been released as of the date of publication of this training, but will be available on the HHS Assistant Secretary for Planning and Evaluation (ASPE) website.

Household Size 100% 138% 150% 200% 250% 300% 400%

1 $12,760 $17,609 $19,140 $25,520 $31,900 $38,280 $51,040

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2 $17,240 $23,791 $25,860 $34,480 $43,100 $51,720 $68,960

3 $21,720 $29,974 $32,580 $43,440 $54,300 $65,160 $86,880

4 $26,200 $36,156 $39,330 $52,400 $65,500 $78,600 $104,800

5 $30,680 $42,338 $46,020 $61,360 $76,700 $92,040 $122,720

6 $35,160 $48,521 $52,740 $70,320 $87,900 $105,480 $140,640

7 $39,640 $54,703 $59,460 $79,280 $99,100 $118,920 $158,560

8 $44,120 $60,886 $66,180 $88,240 $110,300 $132,360 $176,480

*Chart is for 48 contiguous states and the District of Columbia; for Hawaii and Alaska, please visit the HHS ASPE website: https://aspe.hhs.gov/poverty-guidelines. Alt Text Image representing a form with poverty guidelines and figures

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Page: 5 of 14: Silver Plan Variations for Income-based CSRs

Page Text Reduction in Maximum Annual Limitation on Cost Sharing for 2021

Plan Variation (from 70% AV Silver Plan)

Income Range for Individual*

Individual Out-of-Pocket Maximum (standard 2021 limit:

$8,550)

Income Range for Family of

Three*

Family Out-of-Pocket Maximum

(standard 2021 limit: $17,100)

94% AV Silver Plan Variation (for households with a MAGI between 100-150% of the FPL)

$12,760- $19,140

$2,850 $21,720- $32,580

$5,700

7% AV Silver Plan Variation (for households with a MAGI between 150-200% of the FPL)

$19,140- $25,520

$2,850 $32,580- $43,440

$5,700

73% AV Silver Plan Variation (for households with a MAGI between 200-250% of the FPL)

$25,520- $31,900

$6,800 $43,440- $54,300

$13,600

*Please review the 2020 Federal Poverty Guidelines Chart, available by selecting the Job Aids button, to find the dollar ranges for the different percentages of the FPL. These figures are higher in Alaska and Hawaii.

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Page: 6 of 14: Individual Coverage Health Reimbursement Arrangements

Page Text What Is an Individual Coverage HRA? As of January 1, 2020, employers could begin offering their employees an “individual coverage HRA,” which is an HRA that is integrated with individual market coverage or Medicare, instead of offering a traditional group health plan. An individual coverage HRA requires employees and any covered dependents to be enrolled in individual health insurance coverage, or Medicare Parts A and B, or Part C, to receive reimbursements for medical care expenses from the individual coverage HRA. Reimbursements from the individual coverage HRA may include premiums and cost-sharing for individual health insurance coverage or for Medicare (as applicable). How Will Consumers Know if Their Employer Offers Them an Individual Coverage HRA? An employee who is offered an individual coverage HRA will generally get a written notice at least 90 days before the beginning of the individual coverage HRA’s plan year. However, employees who become eligible during the plan year, or later than 90 days before the start of the plan year (such as newly hired employees), will get their notice no later than the date on which their coverage under the individual coverage HRA can begin. The employer notice will include key information about the individual coverage HRA, such as the dollar amount of the HRA offer, the date that coverage under the HRA may begin, and whether the offer extends to dependents (among other things). For more information on the individual coverage HRA employer notice, see the Individual Coverage HRA Model Notice. Alt Text Smiling, middle age female with arms crossed near the house.

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Page: 7 of 14: Individual Coverage HRA Impact on Eligibility for the Premium Tax Credit

Page Text It is important to understand and advise the consumers you assist that individual coverage HRAs may impact their eligibility for the premium tax credit (PTC) for Marketplace coverage.

• A PTC is not allowed for an individual’s Marketplace coverage if he or she is offered an individual coverage HRA that is affordable. This applies to employees as well as spouses and dependents of employees to whom the offer extends.

• If the individual coverage HRA is not affordable, a PTC is allowed if the employee offered the coverage “opts out” of the HRA and the other PTC requirements are met.*

• A PTC is not allowed for an individual’s Marketplace coverage if the individual chooses to be covered by an individual coverage HRA, regardless of whether it is affordable.

Use the "Is Your Individual Coverage HRA Offer Affordable?" worksheet to help the consumers you assist determine if their individual coverage HRA is or is not considered affordable.

For more information on individual coverage HRAs, see:

The HRA Page at CMS.gov

What's an Individual Coverage Health Reimbursement Arrangement (HRA)?

IRS Frequently Asked Questions Regarding Cafeteria Plans

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*Employees generally only have one annual opportunity (based on the employer’s plan year) to opt out of an individual coverage HRA for themselves and on behalf of their dependents.

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Page: 8 of 14: Discontinuation of Coverage for Dual Enrolled Consumers

Page Text The Marketplace conducts periodic data matching (PDM) throughout the year to determine through available data sources whether consumers who are enrolled in a Marketplace QHP with APTC or income-based CSRs are also enrolled in Medicare, Medicaid, or CHIP that qualifies as minimum essential coverage.* New for plan year 2021, when an enrollee provides consent for the Marketplace to end QHP coverage if the Marketplace finds the enrollee to be dually enrolled in other qualifying coverage via PDM, the Marketplace is not required to redetermine the enrollee’s eligibility for APTC/CSRs and may discontinue that enrollee’s coverage. *Note: Most Medicaid coverage is considered minimum essential coverage; however, some forms of Medicaid coverage (e.g., coverage for emergency services or family planning only) are not considered minimum essential coverage. Most CHIP coverage is also considered minimum essential coverage. Medicare Part A and Medicare Part C (otherwise known as Medicare Advantage) are considered minimum essential coverage. Medicare Parts B or D alone are not considered minimum essential coverage. Alt Text Document paper sheet with magnifying glass on it.

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Page: 9 of 14: New Capabilities for the Enhanced Direct Enrollment Pathway

Page Text All issuers and web-brokers that offer the Enhanced Direct Enrollment (EDE) Pathway are required to include the following new capabilities. • Payment functionality. This allows the consumer to make the initial premium payment directly, or allows the consumer to

redirect to the applicable issuer website to make the initial premium payment. • Cancellation and termination functionality. This allows a consumer or agent/broker to terminate coverage for everyone

enrolled in the plan. If the consumer wants to end coverage for just some enrollees, the consumer should call the Marketplace Call Center to ensure the correct termination date is applied.

Alt Text Woman busy browsing on a tablet.

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Page: 10 of 14: Payment Options for Retroactive Coverage

Page Text After they submit their QHP selections to the Marketplace, consumers must pay the first month’s premium. If a consumer is determined to be eligible for retroactive coverage such as through a special enrollment period (SEP) or a successful eligibility appeal, the consumer now has a choice to either:

• Pay the premium amount due for all months of retroactive coverage through the first prospective month of coverage, or

• (New!) Pay the premium for only one month of coverage and receive prospective coverage only. Alt Text Methods and forms of payment, cards, technology online payments.

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Page: 11 of 14: Application of Plan Category Limitations to Newly Enrolled Household Members

Page Text Most common SEP types, like a loss of qualifying coverage; permanent change in primary place of living; or gaining or becoming a dependent through birth, adoption, foster care, or court order are subject to plan category limitations. This means if a consumer wants to change plans during an SEP that he or she qualifies for, the consumer may need to select a new plan within the same plan category as his or her current plan, and wait until the next Open Enrollment if the consumer wants to change to a plan in a different category. New for plan year 2021, if a consumer is newly enrolling in Marketplace coverage with household members who are already enrolled, the newly enrolling household member* can generally either be added to the currently enrolled household member’s plan, or can be enrolled separately in their own plan of any category for the remainder of the year. Current enrollees who do not also qualify for an SEP generally cannot change plans. However, if a plan’s business rules prevent an existing enrollee from adding a newly enrolling household member to their plan, the family can enroll together in a different plan in the same category. If no other plans are available in this category, the family can enroll together in a plan in a category that is one level up or one level down. See Review of FFM SEPs and Plan Category Limitations for more details. *See HealthCare.gov for information on who consumers should include in their household. Alt Text Multi generation male family members posing together at home.

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Page: 12 of 14: Special Enrollment Period for Health Reimbursement Arrangements

Page Text Employees and their dependents who newly gain access to an individual coverage Health Reimbursement Arrangement (HRA) or who are newly provided a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) may qualify for an SEP to enroll in individual coverage through or outside of the Marketplace. The triggering event is the first day on which coverage for the qualified individual, enrollee, or dependent under the individual coverage HRA can take effect, or the first day on which coverage under the QSEHRA takes effect. Generally, qualified individuals will need to apply for and enroll in individual health insurance coverage in time for it to take effect by the date that their individual coverage HRA or QSEHRA starts. Employees with questions about their individual coverage HRA or QSEHRA start date should check their employer notice or contact their employer. If the individual selects an individual health insurance plan before the triggering event, his or her coverage will take effect on the first day of the month following the date of the triggering event or, if the triggering event is on the first day of a month, on the date of the triggering event. If the plan selection is made on or after the day of the triggering event, coverage will take effect on the first day of the month following plan selection. Alt Text Happy young couple using a computer.

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Page: 13 of 14: Reminder: Instruct Consumers to Insert Your NPN on Marketplace Applications

Page Text As a reminder, when a consumer is using the Marketplace Pathway to complete an application (by logging directly into the HealthCare.gov site) the Marketplace application will prompt the consumer to enter your name and National Producer Number (NPN) to indicate that you assisted the consumer. You should always enter your NPN on the application, or instruct consumers to enter your NPN to ensure it will persist on the enrollment transaction if the consumer experiences a change in circumstance. The consumer will encounter a screen with the heading “Application Help” and the questions “Is a professional helping you complete your application?” and “Which type of professional is helping you?”* Make sure the consumer selects the "Agent or Broker" box on this screen. This will produce a new set of fields, including one labeled “National Producer Number,” which is where the consumer should enter your name and NPN to record your assistance with the Marketplace application. If the consumer is re-enrolling and entered a different agent’s or broker’s NPN for the prior plan year, the screen will be pre-populated with that agent’s or broker’s NPN. The consumer should update all information that is pre-populated (e.g., the agent's or broker's name and NPN) as may be appropriate. For more information on recording your NPN on Marketplace applications, review this resource. *Some consumers may experience a different application flow and will see a screen with the heading “Help applying for coverage” and the instruction to “Tell us if you’re getting help from one of these people.” The consumer should select “Agent or Broker” and proceed to enter your name and NPN in the applicable fields.

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Alt Text HealthCare.gov website showing the Application Help Screen

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Page: 14 of 14: Topic Completion

Page Text You have completed What’s New for the Individual Marketplace. You are encouraged, but not required, to complete the optional Individual Marketplace Review for Returning Agents and Brokers, which reviews the eligibility criteria for individuals to enroll in a QHP through the Individual Marketplace, the insurance affordability programs available through the Individual Marketplace and their eligibility requirements, and the rules and procedures related to enrolling in a QHP through the Individual Marketplace. Return to the Menu and proceed to What’s New for Marketplace Privacy and Security. Alt Text An animated figure sitting on top of a square with a green check mark in the center; the animated figure is giving a thumbs-up.

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Topic: 4 of 5: What’s New for Marketplace Privacy and Security Page: 1 of 4: Reminder: Requirement to Execute and Abide by the Privacy and Security Agreement

Page Text Obtaining a consumer’s personally identifiable information (PII) that is submitted on a Marketplace application obligates anyone with access to it to ensure that the information remains private and secure. These obligations are defined within both federal and state laws. The privacy standards and implementation specifications for agents and brokers have not changed for plan year 2021. They are described in Appendix A of the “Agreement Between Agent or Broker and the Centers for Medicare & Medicaid Services (CMS) for the Individual Market Federally-facilitated Exchanges and the State-based Exchanges on the Federal Platform” (Individual Marketplace Privacy and Security Agreement). You must electronically execute this Agreement as part of the Marketplace registration process. You are encouraged to review this Agreement and its Appendix A carefully and must abide by the privacy standards and implementation specifications while engaging in any activity as a Marketplace agent or broker. Alt Text A computer keyboard with a green button labeled "Accept"

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Page: 2 of 4: Reminder: Proper Use of CMS Systems

Long Description Interactive graphic: to the left of the screen is a laptop with a login screen displayed. To the right of the screen is the following text: Agents and brokers accessing the CMS Enterprise Portal and the Direct Enrollment Pathways agree to abide by the terms and conditions of accessing CMS systems when assisting consumers with enrollments in Marketplace plans. Unauthorized or improper use of CMS systems may result in disciplinary action and/or civil and criminal penalties. Below the text are six squares labeled with the following: Single Account, No Sharing of Credentials, Single Login, Limit Person Searches, Obtain Consumer Consent, and Maintain Licensure. When each square is selected, a pop-up box is displayed with accompanying text. Prompt text: Select each item to view the required terms and conditions of accessing CMS systems. Single Account Individuals are allowed to have only one CMS Portal account. No Sharing of Credentials • Only the person creating a CMS Portal Account may use his or her log-in credentials. Sharing log-in credentials is not

allowed. • Agents and brokers may not log in to HealthCare.gov on a consumer's behalf (i.e., using the consumer's HealthCare.gov

ID and password).

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Single Login An agent or broker may log in to his or her CMS Portal account with a single login session and conduct person searches and any other electronic searches through the Direct Enrollment Pathways. If you are logged in and then try to log in again with a new browser window, tab, or other computer, your first session will end. This system check will effectively prevent multiple people from using the same login credentials. Limit Person Searches Users may conduct only one person search at a time during a log in session. Use of scripts and other automation of interactions with CMS Systems or the Direct Enrollment Pathways are strictly prohibited, unless approved in advance in writing by CMS. Users conduct automated activities may have their CMS Portal accounts disabled immediately and without prior notice. This does not apply to scripted interactions with public-facing application programming interfaces maintained by CMS. Obtain Consumer Consent Agents and brokers may only conduct person searches for consumers who have given their consent to assist them with applying for and enrolling in a Marketplace plan. As a best practice, CMS recommends getting this consent in writing. If you have worked with a client in the past and the prior consent has expired, been revoked, or otherwise terminated, you should receive consent from that client again to conduct a person search in connection with enrollment in a Marketplace plan. Conducting person searches for non-Marketplace enrollment purposes (e.g., to enroll the person in a non-Marketplace plan) is not allowed and may result in CMS Portal account suspension and subsequent termination of the agent’s or broker’s applicable Marketplace Agreements and FFM registration. Maintain Licensure Agents and brokers wanting to assist consumers with Marketplace enrollment through HealthCare.gov or any Direct Enrollment Pathway (Classic or Enhanced) must be licensed in each state where they are assisting consumers. Agents and brokers must undergo identity proofing, complete required training, and sign applicable agreements with the Marketplace for the applicable benefit year prior to assisting Marketplace consumers. CMS will disable access to the CMS Portal and the Direct Enrollment Pathways for any agent or broker where CMS is unable to verify state health insurance licensure using the National Insurance Producer Registry and may subsequently terminate the agent’s or broker’s Marketplace Agreements and FFM registration with the agent or broker.

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Page: 3 of 4: Reminder: Immediate Suspension for Risk to Marketplace Operations or Systems

Page Text HHS has authority under 45 CFR §155.220(k)(3) to immediately suspend an agent’s or broker’s ability to transact information with the Marketplace if it discovers circumstances that pose unacceptable risk to Marketplace operations or Marketplace information technology systems until the incident or breach is remedied or sufficiently mitigated to HHS's satisfaction. Applying this provision would suspend an agent’s or broker’s access to the CMS Enterprise Portal, the Marketplace Learning Management System (MLMS), and the Classic Direct Enrollment/Enhanced Direct Enrollment Pathways. Alt Text An image of a computer screen displaying the HealthCare.gov login screen; a red circle with a line through it is superimposed on top of the computer with the word "SUSPENDED" written in white letters

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Page: 4 of 4: Topic Completion

Page Text You have completed What’s New for Marketplace Privacy and Security. You are encouraged, but not required, to complete the optional Privacy and Security Review for Returning Agents and Brokers, which reviews the key privacy standards for agents and brokers who participate in the Marketplace and the controls that agents and brokers can take to protect consumer information. Return to the Menu and proceed to the Summary of Key Resources. Alt Text An animated figure sitting on top of a square with a green check mark in the center; the animated figure is giving a thumbs-up.

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Topic: 5 of 5: Summary of Key Resources Page: 1 of 3: Resources for Agents and Brokers Webpage

Page Text The primary outlet where you can obtain information and updates about working in the Marketplace is the Resources for Agents and Brokers webpage. The links on the right side of this page provide the following resources: • The General Resources link provides a searchable library of guidance, regulations, newsletters, previous webinar slides,

quick reference guides, and more. • The Open Enrollment link provides key resources that will help you assist consumers with eligibility and enrollment for the

current plan year. • The Registration and Training link describes the process and requirements for completing annual Marketplace registration

and training for agents and brokers. • The Small Business Health Options Program (SHOP) link provides key resources and tools for assisting employers in

applying for and offering SHOP coverage. • The Web-brokers link provides information on the application process and other resources for Marketplace web-brokers. • Quick Links go to most frequently used sites and resources. • The Help On Demand link provides key resources for participating in this consumer assistance referral system. • The Video Learning Center link opens a repository of short technical assistance videos to help Marketplace agents and

brokers quickly address common technical issues and application processes. Alt Text Screenshot of the Resources for Agents and Brokers website

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Page: 2 of 3: Other Resources

Long Description Interactive graphic; an image of a computer keyboard with a blue key with the word "Support" written on it. To the left of the image are three buttons. When each button is selected, a popup is displayed with accompanying text. When the popup is closed, the button turns from blue to green and a checkmark is displayed to indicate the action is complete. Prompt Text Select each item to the left to learn more about other valuable online resources for agents and brokers working in the Marketplace. Pop Up Text HealthCare.gov HealthCare.gov This is the official site of the Health Insurance Marketplace and is primarily consumer-facing. It contains information on policies and processes that will help you assist consumers with eligibility and enrollment for the current plan year. Use the “Search” function to search topics by key word. The HealthCare.gov home page also contains a "For Agents and Brokers" link at the bottom of the page to make it easier for you to get to the Agents and Brokers Resources webpage. Marketplace.CMS.gov The official Marketplace information source for assisters and outreach partners is https://marketplace.cms.gov/. This site contains links to:

36 This content is valid through July 2021.

• Applications, forms, and notices • Technical assistance resources • Outreach and education • Assister Training Image: Homepage of the Marketplace.CMS.gov website Other Resources Refer to the following table for descriptions and links to other valuable resources for information to assist agents and brokers working in the Marketplace. Click here for a list of these and other useful websites for agents and brokers. Other Resources

Resources Description Link Marketplace Registration Tracker

Searchable database that allows users to look up their Marketplace registration status with the NPN and ZIP Code saved in their Marketplace Learning Management System (MLMS) profile for the current plan year

https://data.healthcare.gov/ab-registration-tracker/

Registration Completion List

Public list of agents and brokers who have completed Marketplace registration; used by issuers to verify your eligibility for compensation for assisting with consumer enrollments

https://data.healthcare.gov/ffm_ab_registration_lists

Find Local Help A tool available on HealthCare.gov that enables consumers to search for a local, Marketplace-registered agent or broker with an active licensure status in a valid health-related line of authority to assist with FFM enrollment

https://localhelp.healthcare.gov/

CMS Enterprise Portal Allows you to securely complete identity-proofing and access the MLMS to complete annual, required agent and broker training and registration

https://portal.cms.gov

Agent and Broker NPNs Provides a search function to determine the correct NPN to enter in your MLMS profile and on Marketplace applications

www.nipr.com/PacNpnSearch.htm

LinkedIn for Marketplace Agents and Brokers

Contains posts with announcements, new resources, upcoming webinars, and more information for Marketplace agents and brokers

https://www.linkedin.com/showcase/cms-ab

Help Desk and Call Centers The Marketplace operates a number of Help Desks and Call Centers to help agents and brokers get technical assistance with questions or issues. Check out this resource for descriptions and contact information for each.

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Page: 3 of 3: Module Completion

Page Text Congratulations! You have completed the What's New For Returning Agents and Brokers Training. Alt Text A person standing on a mountain peak with arms her outstretched