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ACA Open Enrollment: Key Dates and Tips for Insurance Agents

Posted by www.psmbrokerage.com Admin on Wed, Jul 10, 2024 @ 01:57 PM

ACA Open Enrollment-3

Here are some important dates and tips for Insurance Agents during ACA Open Enrollment.

Hey there everyone! It’s that time of year again—ACA Open Enrollment is just around the corner. These are critical dates as you’re aware, and of course, a little reminder never hurts. So let’s break it down in a simple and straightforward way. Bookmark this page for a future reminder. We’ll keep it updated for you.

  Important Dates for 2024 Open Enrollment

November 1, 2023: Open Enrollment begins. This is the first day clients can start enrolling in or changing their health plans for the upcoming year.

December 15, 2023: Deadline for coverage that starts on January 1, 2024. If your clients want their coverage to begin on the first day of the new year, they must enroll by this date.

January 15, 2024: Open Enrollment ends in most states. This is the final day for clients to enroll in or change plans for coverage that starts on February 1, 2024.

January 16, 2024: For the majority of states using the federal marketplace, this is the deadline to enroll for 2024 coverage.

Note: The past 2 years, 2022 and 2023, coverage ran from Nov. 1st to Jan. 15th. In 2024, there is a one day extension due to a federal holiday.

 State-Specific Deadlines

While 37 states follow the January 16 deadline for ACA Open Enrollment, some states like to be different. It’s important to these special cases in mind during ACA Open Enrollment:

  • California: Open Enrollment extends to January 31.
  • New York: Enrollments are allowed until March 31.
  • Idaho: Ends earlier on December 15.
  • Massachusetts: Ends on January 23.
  • Rhode Island: Also extends to January 31.

 Special Enrollment Periods (SEP)

Special Enrollment Periods allow your clients to enroll in or change their health insurance plans outside the Open Enrollment period if they experience certain life events. Here are some of those qualifying events for the SEP:

  • Marriage or Divorce: Getting married or finalizing a divorce that results in loss of coverage.
  • Birth or Adoption: Having a baby, adopting a child, or placing a child for adoption or foster care.
  • Loss of Coverage: Losing existing health coverage due to job loss, aging out of a parent's plan, or other qualifying reasons.
  • Move: Changing your primary residence to a new area that offers different health plan options.
  • Other Qualifying Events: Including changes in income, gaining citizenship, or leaving incarceration.

 Year-Round Enrollment Options

Additionally, there are certain groups and coverage types who are eligible for year-round enrollment without the need for a Special Enrollment Period:

  • Medicaid and CHIP: Individuals eligible for Medicaid or the Children’s Health Insurance Program (CHIP) can enroll at any time.
  • American Indians and Alaska Natives: These groups can enroll in or change plans once per month throughout the year.
  • Other State-Specific Programs: Some states have additional programs like New York's Essential Plan or Minnesota's MinnesotaCare that offer year-round enrollment for eligible individuals.

 Tips and Reminders

  1. Start Early: Encourage your clients to start thinking about their health insurance needs now. The earlier they begin, the less stressful the process will be.
  2. Educate Clients on Their Options: Many clients are unaware of the various plans and subsidies available to them. Take the time to explain the differences between Bronze, Silver, Gold, and Platinum plans, and how income-based subsidies can make coverage more affordable.
  3. Highlight the Benefits of Early Enrollment: Enrolling early can help clients avoid the last-minute rush and ensure their coverage starts on time. Plus, it gives them more time to compare plans and make informed decisions.
  4. Use Technology: Utilize online tools and resources to help clients compare plans. The HealthCare.gov site allows clients to preview plans and prices before officially enrolling.
  5. Stay Informed: Keep up-to-date with any changes or extensions in enrollment periods, as well as new regulations or updates that might affect your clients.

image-png-Jun-18-2024-01-40-48-4364-PM

Additional Resources:

 

Tags: ACA, OEP

How to Get FFM Certified to Sell Health Insurance

Posted by www.psmbrokerage.com Admin on Wed, Jul 10, 2024 @ 01:51 PM

 

FFM

How to Get Your FFM Certification to Start Selling Health Insurance

In this guide we’ll walk you through the steps required to get certified to sell health insurance plans on the Federally Facilitated Marketplace (FFM). Our goal here is to help ensure you have the knowledge and credentials needed to succeed in this rewarding field, and getting certified is the first step.

FFM certification is your gateway to serving a broader client base and growing your insurance business with the right mix of products and some help from your FMO.

What is FFM Certification?

understanding ffm  certificationThe Federally Facilitated Marketplace (FFM) certification is a requirement for insurance agents who want to sell ACA health plans. This is an annual certification that ensures that agents are knowledgeable about ACA regulations and can effectively guide clients through the marketplace enrollment process.

Why is FFM Certification Important?

  • Compliance: Ensures you meet federal guidelines for selling ACA plans.
  • Market Access: Allows you to sell plans on the federally facilitated marketplace, giving you access to a vast customer base.
  • Credibility: Enhances your credibility and trustworthiness among clients seeking ACA health coverage.
  • Business Growth: Opens up new revenue streams and client opportunities in the growing ACA marketplace

Setting Up Your CMS Enterprise Account

Before you can start the FFM certification process, you'll need to set up a CMS Enterprise Portal account. This portal will be your gateway to accessing the necessary training and resources for FFM certification each year.

It's a one time deal and it's a pretty quick process. Just make sure you save the log in info. somewhere safe. You don't want to be resetting the password every time you login, like you do with your email... Ya, I see you.

Step-by-Step Guide to Creating a CMS Enterprise Portal Account

  1. Visit the CMS Enterprise Portal Website: Navigate to the CMS Enterprise Portal (https://portal.cms.gov) and select the New User Registration option.
  2. Provide Personal Information: Enter your personal details, including your name, email address, and security questions.
  3. Create a Username and Password: Choose a unique username and a strong password that meets the CMS security requirements.
  4. Verify Your Email: Check your email for a verification link and follow the instructions to verify your account.

Setting up your CMS Enterprise Portal account is a crucial first step in the FFM certification process. With this account, you’ll gain access to the necessary tools and resources to complete your certification efficiently.

Requesting the FFM Agent Broker Role

Once you have your CMS Enterprise Portal account set up, you're ready to request the FFM Agent Broker role. This role is necessary for accessing the Marketplace Learning Management System (MLMS) and completing your certification training.

Detailed Process of Requesting the FFM Agent Broker Role

  1. Login to CMS Enterprise Portal: Use your newly created credentials to log in.
  2. Access Role Request Page: Navigate to the "My Access" page and select "Request Access Now."
  3. Select FFM/Training: Choose the appropriate role from the list, specifically the “FFM Agent Broker” role.
  4. Submit Your Request: Complete any additional information required and submit your request.

By securing the FFM Agent Broker role, you’ll be ready to begin your Marketplace Learning Management System (MLMS) training and move one step closer to becoming FFM certified.

It's starting to get real, don't stop now, you're just a couple steps away.

Explanation of the Identity Proofing Process

  1. Login to CMS Enterprise Portal: Use your credentials to log in.
  2. Start the Identity Proofing Process: Navigate to the identity proofing section and follow the on-screen instructions.
  3. Provide Personal Information: Enter your personal details, including your Social Security Number (SSN), date of birth, and address.
  4. Answer Security Questions: Respond to questions based on your credit history to verify your identity.

Completing identity proofing successfully allows you to proceed with your FFM certification, ensuring secure access to all necessary training and resources.

It may seem tedious, but it's important to ensure that people are who they say they are before they start helping people make one of the biggest decisions of their lives.

Confirming Your MLMS Profile

Confirming Your MLMS ProfileOnce your identity is verified, the next step is to confirm and complete your MLMS (Marketplace Learning Management System) profile. This profile is used for accessing training modules and other resources necessary for your FFM certification.

Filling Out and Verifying Your MLMS Profile

  1. Access Your MLMS Profile: Log in to the CMS Enterprise Portal and navigate to the MLMS section.
  2. Complete Required Fields: Fill out all required fields accurately, including your personal and professional information.
  3. Verify Your Information: Double-check the entered information for accuracy and completeness to avoid any processing delays.
  4. Save and Submit: Save your completed profile and submit it for verification.

Don’t rush through creating your profile. A well-maintained profile reflects your professionalism and readiness to serve clients.

Completing MLMS Training and Agreements

After confirming your MLMS profile, the next step is to complete the required training modules and agreements. These are essential to ensure you have the necessary knowledge to sell ACA plans effectively.

 Overview of the Training Modules and Required Agreements

  1. Access Training Modules: Log in to the MLMS and navigate to the training section.
  2. Complete Required Courses: Follow the curriculum, which includes modules on ACA regulations, plan options, and enrollment procedures.
  3. Sign Required Agreements: Review and sign all necessary agreements that certify your understanding and compliance with ACA and FFM regulations.

Strategies for Efficiently Completing the Training

  • Set Aside Dedicated Time: Schedule specific times to complete your training to avoid interruptions.
  • Take Notes: Keep detailed notes during the training to help with understanding and future reference.
  • Utilize Available Resources: Make use of additional resources such as guides and FAQs provided within the MLMS.

Completing the MLMS training and agreements is a critical step in the certification process, ensuring you are well-prepared to assist clients with their ACA insurance needs.

You're so close, you have no idea. Keep going.

Verifying Your Registration Status

Verify RegistrationAfter completing your training and signing the necessary agreements, it’s crucial to verify your registration status to ensure you are officially certified.

Print Your Certificate and Confirm Registration

  1. Log in to MLMS: Use your credentials to access the MLMS.
  2. Navigate to Certification Section: Find the section where you can view your certification status.
  3. Print Your Certificate: Once you see that you have completed all requirements, print your certificate for your records.
  4. Check the FFM Registration Completion List: Verify that your name appears on the official list to confirm your certification status.

Ensure all training modules and agreements are completed and saved. If your name does not appear on the list, contact MLMS support for assistance.

Verifying your registration status is the final step to confirm your eligibility to sell ACA plans, ensuring you are fully prepared and recognized as a certified agent.

Ok, you can start doing a little happy dance now. You did it! 

Maintaining Your Certification

Getting FFM certified is just the beginning. To continue selling ACA plans, you need to maintain your certification by staying updated with annual requirements.

Annual Renewal Process and Updates

  1. Annual Training: Complete required annual training modules each year to stay current with ACA updates and regulations.
  2. Renew Agreements: Review and sign any updated agreements or attestations as part of the renewal process.
  3. Monitor CMS Communications: Stay informed about any changes or updates in certification requirements through CMS emails and notifications.

Maintaining your certification ensures that you remain compliant and knowledgeable, ready to provide the best service to your clients in the evolving ACA marketplace.

Conclusion

ConclusionBecoming FFM certified is necessary for insurance agents looking to expand their portfolio and offer ACA health insurance plans.

This certification not only opens up new revenue streams but also enhances your credibility and trustworthiness among clients. By following the steps outlined in this guide, you can efficiently navigate the certification process, from setting up your CMS Enterprise account to completing training and maintaining your credentials.

Start your journey today and grow your insurance business with help from a an experienced FMO like PSM Brokerage. Our staff has decades of experience helping insurance agents like you build a winning portfolio and grow your business.

If you have any questions, we’re here to help. 1-800-998-7715.

Helpful Resources

CMS Enterprise Portal Login: https://portal.cms.gov/portal/

CMS Marketplace Resources: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces

NAHU Continuing Education: https://nabip.org/professional-development

National Association of Insurance and Financial Advisors (NAIFA): https://www.naifa.org/

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Tags: ACA, ffm certification

Unlock New Opportunities: Join Us in Selling Health Insurance!

Posted by www.psmbrokerage.com Admin on Tue, Jun 18, 2024 @ 01:27 PM

ACA Unlock-1

With the ever-changing landscape of health insurance, now is the perfect opportunity to broaden your horizons and maximize your business prospects.

We are thrilled to extend an invitation to you to partner with us in providing Affordable Care Act (ACA) health plans to your clients.

Comprehensive Support: Our dedicated team provides extensive training, marketing resources, and personalized support to ensure you have everything you need to succeed.

Access to Top Carriers: Partner with leading insurance carriers and offer a wide range of ACA plans tailored to meet diverse client needs.

Streamlined Enrollment Process: Our user-friendly platform simplifies the enrollment process, allowing you to focus on what you do best – building relationships and closing sales.

Lucrative Commissions: Earn competitive commissions while helping individuals and families access affordable healthcare coverage. Your success is our success.

Ongoing Education: Stay ahead of industry trends and updates with our regular training sessions and webinars designed to keep you informed and equipped with the latest knowledge.

https://www.psmbrokerage.com/product-portfolio/major-medical

Join a Winning Team

As a valued partner, you will have access to our proven strategies, tools, and resources that have helped countless agents achieve remarkable success. Together, we can make a significant impact on the lives of individuals and families seeking quality healthcare coverage.

Get Started Today!

If you're ready to take your business to the next level and unlock new opportunities with ACA health plans, don't hesitate to reach out. Contact us to learn more and begin your journey with us.

Thank you for considering this exciting opportunity. We look forward to partnering with you and driving success together.

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Tags: ACA, Major Medical

ACA Marketplace: New CMS Consent Rules Effective 6/18/23

Posted by www.psmbrokerage.com Admin on Mon, Jun 19, 2023 @ 10:50 AM

New CMS Consent Rule

Source: HealthSherpa

CMS covered their new rules around Consent and Review for all marketplace enrollments at their CMS Summit for Agents and Brokers on 5/24/2023. These rules build upon the existing rules that were outlined in the 2022 Understanding Marketplace Compliance Rules & Regulations slides, as well as the various FAQs that address Consent and PII rules and regulations.

When comparing the 2023 Understanding Key CMS Rules and Regulations to Maintain Marketplace Compliance slides to the Rules and Regulations from previous plan years, the following are some of the key additional requirements that will need to be met in addition to past guidance. This is not an exhaustive list, so be sure to review the 2023 Rules and Regulations yourself when developing your consent documenting systems for PY 2024.

Consent Documentation Requirements:

  • The consumer or their authorized representative must take an action to produce the documentation;

  • Provide consumers a process with which they can rescind consent;

  • A description of the scope, purpose, and duration of the consent provided by the consumer or their authorized representative.

  • In addition to the previously required fields.


Review Documentation Requirements:

  • Maintain documentation stating a consumer or their authorized representative has reviewed and confirmed their application information is accurate (45 C.F.R § 155.220(j)(2)(ii)(A)(1)-(2)). (Referred to as “Review Documentation Requirements”);

  • The consumer or their authorized representative takes an action to produce the documentation;

  • The documentation must contain, at a minimum, the following information:

    • The date the information was reviewed;

    • The name of the consumer or their authorized representative;

    • An explanation of the attestations at the end of the eligibility application; and

    • The name of the assisting agent, broker, or web-broker.

  • The agent, broker, or web-broker must maintain the documentation for a minimum of 10 years.


Protecting Consumer PII:

  • You must provide consumers the opportunity to opt-in and allow you (and your agency, if applicable) to use their PII (e.g., through the record of consent). You should also provide a mechanism through which the consumer, or their authorized representative, can limit the use of their PII.

  • PII may only be used for the authorized functions discussed earlier, in the context of completing an application for QHP, APTC, or CSRs eligibility, if applicable, or enrolling in a QHP, or any data transmitted from or through the Marketplace, if applicable.

  • PII may not be used for any other purposes not outlined in these agreements without the explicit consent of the consumer or their authorized representative.


Third Party Relationships:

  • Agents and brokers and any third party with which they have entered into a business relationship must adhere to requirements for the use and disclosure of all consumer PII or protected health information (PHI), including all PII/PHI collected by the third party.

  • Agents and brokers are required to obtain consent from the consumer or their authorized representative. Third party means, such as lead-generators, do not constitute consent in a manner that complies with 45 C.F.R. § 155.220.

    • For example, consumers merely checking a box to indicate that they attest to being enrolled in Marketplace coverage does not constitute consumer consent for purposes of complying with CMS Marketplace requirements.


System Usage:

  • CMS systems that agents and brokers access when assisting consumers, include, but are not limited to, the CMS Enterprise Portal, HealthCare.gov, and HealthSherpa EDE and DE Pathways.

    • Only maintain one CMS Enterprise Portal account, accessible by the registered agent or broker.

    • Only conduct one log-in session at a time.

    • No scripting or automation without written CMS permission.


The documentation requirements go into effect beginning June 18th, 2023.
They are not retroactive; agents do not have to go back and gather documentation for applications completed before this date, but should implement these practices moving forward. We do expect further guidance in the form of Clarifying FAQs to come from CMS by or shortly after this date.

Remember, all of the rules and regulations around consent and client review are to help you protect your client and your relationship with your client.

 Download the CMS Model Agent Broker Consent Form.

Source: HealthSherpa

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Tags: CMS, ACA

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