2015 Renewals & Redetermina3ons: Individuals and Families. Connect for Health Colorado

Transcription

1 2015 Renewals & Redetermina3ons: Individuals and Families Connect for Health Colorado

2 Annual Eligibility Redetermina3ons & Plan Renewals Month- to- Month View 2

3 September Customers may receive a no2ce from their health insurance carrier no2fying them of any changes in their current plan selec2on. Many plans may have changes including changes in provider networks, premiums, deduc2bles, and copays. Connect for Health Colorado s customer e- newsleber Connect to Coverage will con2nue to provide updates on the renewal process and what to expect. Connect for Health Colorado begins online training for our cer2fied partners. Training material will be developed for customer educa2on and outreach. 3

4 October By October 1 Customers will receive a no2ce from their insurance carrier if their current plan will not be available in the upcoming year. By October 31 OR Customers will receive 1 of 2 no2ces sent jointly from Connect for Health Colorado and their individual carrier (co- branded). Eligible for Plan and Tax Credit Renewal Customer does NOT need to take any ac6on. If we are able to redetermine a customer s federal tax credit and their current plan is being offered in the upcoming year, customers will receive no2fica2on indica2ng they will be automa2cally re- enrolled with their tax credit by December 15 th. Re-apply and Shop Customer must re- apply and shop by December 15 for January 1 coverage. We cannot auto- renew / auto- redetermine. 4

5 November Beginning November 9, customers can preview plans that will be available for the next calendar year at ConnecForHealthCO.com. Open enrollment begins November 15! Current customers can start to update 2015 eligibility, compare, enroll and purchase plans. Connect for Health Colorado is required to verify income informa2on each year for enrollees receiving federal tax credit. If we receive new informa2on that might make a customer newly ineligible for the tax credit, we must no2fy the customer of this data mismatch. If a customer receives a no2ce to re- apply for the federal tax credit, they must re- submit their eligibility applica2on and select their plan by December 15 th to avoid a gap in coverage. 5

6 December By December 15 For January 1 If customer makes no change to their account and is eligible for auto- redetermina2on, they will be automa2cally re- enrolled in their plan. By December 15 For January 1 If a customer received a no2ce from Connect for Health Colorado indica2ng that they must re- apply and select their plan, they must do so by December 15 for January 1 coverage. By December 25 For January 1 Customer s first payment for 2015 plan year must be sent directly to their carrier by December 25 to be ac2ve on January 1. 6

7 Annual Eligibility Redetermina3ons & Plan Renewals Customer Walk- Thru 7

8 Why Will Customers Receive Different NoEces? Eligible for Plan and Tax Credit Renewal No6ce Must Re- apply and Shop No6ce Must Re- apply and Shop No6ce (post federal verifica6on) Customer is s2ll eligible for plan next year Plan is available next year Connect for Health Colorado is able to redetermine the tax credit Any household member turns 65 by renewal date Any household member is no longer eligible for plan (i.e. age out) Plan is not offered next year Connect for Health Colorado does not have enough informa2on to redetermine the tax credit Federal verifica2on determines the household has no income informa2on Federal verifica2on determines a large difference (+/- 50%) between the informa2on they have and the Marketplace for a household Federal verifica2on determines the customer s FPL is above 500% Federal verifica2on determines one or more members of the household are in the Medicaid or CHP+ income range 8

9 Customers Not Receiving a Tax Credit Eligible for Plan Renewal Notice Yes Eligible for Plan Renewal? Customer Actions 1. Customer does nothing (auto-renewal) 2. Customer Opts-In 3. Customer Opts-Out and shops for a plan 4. Customer Opts-Out and does NOT shop No Must Re-apply and Shop Notice Customer Actions 1. Customer shops for a plan 2. Customer does NOT shop for a plan 9

10 Customers With a Tax Credit Eligible for Plan & Tax Credit Renewal Notice Yes Eligible for Auto- Redet & Plan? Fail Income Verification Yes No Customer Actions Customer Actions 1. Customer does nothing (auto-redetermination & renewal) 2. Customer Opts-In 3. Customer Opts-Out and shops for a plan 4. Customer Opts-Out and does NOT shop No Must Re-apply and Shop Notice (post federal verification) Must Re-apply and Shop Notice Customer Actions 1. Customer re-apply & shops for a plan 2. Customer does NOT reapply and shop for a plan 10

11 Annual Eligibility Redetermina3ons & Plan Renewals What You Can Expect 11

12 What You Can Expect October-November 14 Connect for Health Colorado will provide Carriers, Brokers, and Assistance Sites no2ce templates Connect for Health Colorado is targe2ng October to send Carriers, Brokers, and Assistance Sites customer renewal lists to help you understand which no2ces your customers will receive Previewing plans will be available on Connec`orHealthCO.com beginning November 9. Current customer reported changes prior to Nov 15 will only be used for 2014 eligibility. November 15-December Connect for Health Colorado will proac2vely outreach to customers via and phone campaigns to help them through the process, if needed Auto- renew Opt- in/opt- out and 2015 change repor2ng will be available in customers accounts beginning November 15 If you and your customer placed a plan in The Cart prior to Open Enrollment, you must come back to the Marketplace and finalize purchase Auto- renewals will be sent to carriers by December 15th

13 Annual Eligibility Redetermina3ons & Plan Renewals Key Messages 13

14 Overarching Messages Open enrollment at Connect for Health Colorado takes place from November 15, 2014 to February 15, This is the 2me to renew your health insurance plan or shop for a new plan for Renew or enroll in a new plan by December 15 to have your coverage start on January 1. There are a few easy steps you can take to make sure you are choosing the right plan for you and your family. Learn about any changes to your plan in Plans change from year to year. Rates can go up and down and provider networks can change. You will receive a no2ce from your insurance company and Connect for Health Colorado explaining any changes to your plan for next year. It s important to see if and how your plan is changing to know if it s s2ll right for you. Go to Connec`orHealthCO.com to explore all of your op6ons for 2015 and see if you qualify for financial help. Compare plans based on cost, coverage levels and provider covered by each plan to make sure you re gekng the best plan for you. Make sure Connect for Health Colorado has your most updated informa6on so you get the right amount of financial help for the plan you choose. Changes to things like your income and the number of people in your household can impact the financial help you receive. If you want to change plans, visit us online at Connec`orHealthCO.com or call 855- PLANS- 4- YOU so you can stay covered in 2015! You can also get free in- person help understanding your op6ons and picking your plan. 14

15 Possible Scenarios Scenario One: Customer has a reduced tax credit amount in 2015 The amount of financial help you get to pay for your plan is based on a few things: your income, household size and the cost of your health plan s monthly premium. If any of these things change, it can impact the amount of financial help you receive. If the cost of your monthly premium is less than before, you may get less financial help to pay for your plan. It s important to explore all of your plan op2ons for 2015 at Connec`orHealthCO.com to make sure you re gekng the best deal for you. You may find a similar plan at a lower cost. There are more than X plans available in your area with different rates, coverage levels and provider networks. Shop and compare to find a plan that meets your needs and budget. 15

16 Possible Scenarios Scenario Two: Customer has increased tax credit amount in 2015 The amount of financial help you get to pay for your plan is based on a few things: your income, household size and the cost of your health plan s monthly premium. If any of these things change, it can impact the amount of financial help you receive. With more financial help, you will likely pay less for your monthly premium. If the cost of your plan is higher than before despite your higher tax credit, you can visit Connec`orHealthCO.com to shop for more plan op2ons. There are more than X plans available in your area that you can use your increased tax credit towards all with different rates, coverage levels and provider networks to choose from. Shop and compare to find the best plan for you. 16

17 Possible Scenarios Scenario Three: Customer with no tax credit in 2015 The amount of financial help you get to pay for your plan is based on a few things: your income, household size and the cost of your health plan s monthly premium. If any of these things change, it can impact the amount of financial help you receive. Individuals earning up to $45,960 and a family of four earning up to $94,200 are likely eligible for financial help. Visit Connec`orHealthCO.com to see all of your op2ons for There are more than X plans available in your area to choose from. 17

18 Possible Scenarios Scenario 4: Customer with network changes in 2015 Plans can change from year to year, including the doctors and hospitals covered by your health plan. You will receive a no2ce from your insurance company and Connect for Health Colorado explaining any changes to your plan for next year. It s important to understand how your plan might change so you can decide if it s s2ll right for you. Visit Connec`orHealthCO.com to see all of your op2ons for There are more than X plans available in your area so you can choose a plan that fits your needs and budget. 18

19 Possible Scenarios What s Not Changing While plans can change from year to year, here are a few things that won t change: o All plans offered through Connect for Health Colorado cover the essentials, including doctor visits, hospital stays, prescriptions, and more plus preventive care at no cost to you. o All plans cover pre-existing conditions and there are no annual or lifetime limits on coverage. o Connect for Health Colorado is the only place where you can get financial help to pay for your plan. Individuals earning up to $45,960 and a family of four earning up to $94,200 can qualify. 19

20 Annual Eligibility Redetermina3ons & Plan Renewals Resources 20

21 Links to DOI NoEce Language Plan Discon2nuance Bulle2n click here Reasonable Modifica2on Bulle2n click here Renewal and Redetermina2on Bulle2n click here 21

22 Webinar and Infographic Connect for Health Colorado Annual Plan and Tax Credit Renewal webinar recording click here Connect for Health Colorado Road to Renewal infographic click here 22

23 23 Ques3ons

24 QuesEons Visit our Help Center hbps://connec`orhealthco.custhelp.com/app/answers/list your Connect for Health Colorado Broker or Assistance Network Representa2ve o AssistanceNetwork@ConnectforHealthCO.com o CacProgram@ConnectforHealthCO.com o Pmeyer@ConnectforHealthCO.com 24