Navigator Manual - 08.29.16

What You Need to Know about Health InsuranceApplying for Health InsuranceApplying for a Marketplace Plan if You Can GetHealth Insurance through Your JobAbout this Most people can get health insurance from their jobs (or a familyfact sheet member’s job). But now you can buy health insurance through the federal health insurance marketplace or your state’s health insurance marketplace. And if the insurance you get through your job doesn’t pay for enough of your health care or is too expensive, you may also be able to get financial assistance to help pay for a marketplace plan. This fact sheet will help you decide whether to stay with your job’s plan or buy a plan in the marketplace.1. If I can get health insurance from my job or a familymember’s job, can I buy insurance through the marketplaceinstead?Yes. You can always choose to buy insurance in the Insurance that you get from yourmarketplace. But you may have to pay the full price job (or a family member’s job) isof the plan. Most people who can get insurance often called a “workplace plan.”through a job can’t get financial assistance to pay fora marketplace plan.2. If I can get health insurance from my job or a familymember’s job, can I still get financial assistance to buy amarketplace plan?Maybe. If you can get insurance from a job, you may be able to get financial assistance to buy amarketplace plan. When you apply for this financial assistance, the marketplace application will askyou some questions to figure out:Does your workplace plan pay for enough of your health care? Does the plan pay for at least60 percent of health care costs (does the plan meet “minimum value”)? (See page 2.)Is your workplace plan too expensive? What is the cheapest plan that pays for at least 60percent of health care costs? Would you have to pay more than 9.56 percent of your annualhousehold income on the premiums for that plan to cover just yourself (and not any otherfamily members)?Updated October 2015 www.FamiliesUSA.org

Applying for a Marketplace Plan if You Can Get Health Insurance through Your Job3. If I can get insurance for family What is “minimum value”?members through my job, but that familyplan is too expensive, can I buy a plan for Workplace health insurance thatthe rest of my family in the marketplace pays for at least 60 percent ofinstead? And can I get financial health care costs (on average) isassistance to help pay for that plan? said to meet “minimum value.” If your workplace insuranceYou can buy a plan for your family members in the marketplace. meets minimum value, thatBut you can’t get financial assistance for that plan unless one of means it pays for enough ofthese things is true of your workplace plan: your health care and that you can’t get financial assistance for Your workplace plan doesn’t pay enough for health care (it a marketplace plan (unless your does not meet minimum value) workplace plan is too expensive). ORThe cheapest workplace plan that pays enough for health care is too expensive for you (basedon the amount that you’d pay for an employee plan, not a family plan)If the workplace plan doesn’t pay for enough of your health care or is too expensive, you may beable to get financial assistance for a marketplace plan.When the marketplace figures out if the plan your job offers is too expensive, it looks at how muchit costs you to pay for an employee plan (just for you), not a family plan (what you’d buy for yourfamily, which usually costs more). So, even if a family plan is too expensive for you, if an individualemployee plan is not too expensive, then the marketplace will say that your workplace coverageis affordable for any family members who could be covered by that family plan. You can’t getfinancial assistance to help pay for a plan for these family members in the marketplace.4. If my child is a young adult under MORE INFORMATIONage 26 and is on the health plan I havethrough my job, can he get financial Learn more about getting financialassistance to buy a marketplace plan assistance.instead? Fact sheet: “Getting FinancialIt depends. Do you list that child on your taxes as a dependent? Assistance to Pay for Health Insurance”If you don’t list that child on your taxes, and if she files taxes onher own, she may be able to get financial assistance to buy amarketplace plan. To do this, she must apply for health coverageand financial assistance in the marketplace herself.2 WHAT YOU NEED TO KNOW ABOUT HEALTH INSURANCE

Applying for a Marketplace Plan if You Can Get Health Insurance through Your JobIf you do list that child on your taxes as a dependent, she won’t be able to get financialassistance to buy a marketplace plan on her own unless you are both eligible to get financialassistance because your job’s plan doesn’t pay enough for health care or is too expensive.5. If I’m retired and I get health insurance through a formerjob, or if I lost my job and have a COBRA (continuation)plan, can I still get financial assistance to buy a plan in themarketplace?Yes. If the only insurance you can get is retiree health insurance or a COBRA plan from a formerjob, you may be able to get financial assistance to buy a health plan in the marketplace insteadof COBRA.6. What questions will the marketplace application askabout my workplace health insurance, and how can I getanswers to those questions?The marketplace application asks for your employer’s contact information whether you currently get health insurance through your job, or when your health insurance would start if you signed up for a plan through your job who else in your family could get health insurance through your job whether the employer offers a health plan that meets minimum value the cost of the cheapest employee plan that also meets minimum value whether the employer will change the insurance it offers in the future and when it will change that insuranceAsk your employer for this information, and have it ready before you start filling out themarketplace application. Make sure the plan that you get information on is the cheapest plan youremployer offers for an individual employee that also meets minimum value.Instead of asking your employer for the information listed above, you can go to the marketplacewebsite and use the search tool to find a form called the “Employer Coverage Tool.” Print out thisform and ask your employer’s Human Resources department to fill it out.www.FamiliesUSA.org 3

Applying for a Marketplace Plan if You Can Get Health Insurance through Your Job 7. Do I have to ask my employer for this information, or can I get it another way? If you already have documents from your employer with the information you need, you may not need to ask for more information. For example, your employer is required to provide you with a document called the “Summary of Benefits and Coverage” for each plan it offers. This document tells you whether your employer’s plan pays for enough health care (meets minimum value). Your employer may also provide other documents that tell you how much employees have to pay in monthly premiums for each workplace plan. Make sure that you get information about the premiums you would pay for the cheapest plan your employer offers for an individual employee that also meets minimum value. If your employer has a wellness program or any other program that might affect your monthly premiums, this may change the information you need to provide about your premiums on the marketplace application. In this case, it is best to ask your employer to complete the Employer Coverage Tool. What are wellness programs? Wellness programs are programs that employers offer to their employees that are designed to improve employees’ health or increase their healthy behaviors. Some wellness programs that are offered alongside workplace health insurance plans can change the monthly premium you pay depending on whether you participate in wellness activities or achieve certain health goals. For example, some wellness programs charge lower premiums to employees who do not smoke or who participate in activities that help people stop using tobacco. Programs might also charge lower premiums if employees manage their weight or exercise regularly. Does your employer have a wellness program that could affect your premiums? If it does, there is a special rule about what premium amount you should list on your marketplace application. You may need to ask your employer about the amount of that premium when you fill out the application.4 WHAT YOU NEED TO KNOW ABOUT HEALTH INSURANCE

Applying for a Marketplace Plan if You Can Get Health Insurance through Your Job8. What can I do if I think my employer is discriminatingagainst me because I am applying for or getting healthinsurance in the marketplace?If you believe your employer is discriminating against you, file a complaint with the OccupationalSafety and Health Administration within 180 days. You can do this by calling 1-800-321-6742.9. If I can get health insurance through my current job orthrough a family member’s job, does it matter if I havealready signed up for a workplace plan when I apply forfinancial assistance to buy a marketplace plan?No. The only things that matter are how much you pay for that workplace plan and how muchhealth care it pays for.10. If I have health insurance through my job, but I canget financial assistance to buy a marketplace plan, can Istay in my job’s plan until the insurance I get through themarketplace starts?Yes. If you have health insurance through your job when you apply for a marketplace plan, youcan stay in your job’s plan until the marketplace plan starts.11. After I get a marketplace plan, what MORE INFORMATIONhappens if I can get a new plan through ajob? Learn about how financial assistance affects your taxes.If you are getting financial assistance for a marketplace plan, youmust tell the marketplace when you are offered a new health plan Fact sheet: “How Gettingthrough a job. If that new plan is affordable and pays for enough Financial Assistance to Paycare, you won’t be eligible for financial assistance for the rest of the for Health Insurance Affectsyear. If you continue to use financial assistance anyway, you will Your Taxes”have to pay some or all of this money back when you do your taxes. www.FamiliesUSA.org 5

12. What happens if I’m getting financial assistance for amarketplace plan and I start making more money?If you are getting financial assistance for a marketplace plan and you start making more money,you must tell the marketplace about your new income. You may need to lower the amount offinancial assistance you get to avoid paying back money when you do your taxes.Even if your new income makes the plan you can get through a job affordable, you can stay inyour marketplace plan and keep getting financial assistance until you have an opportunity toenroll in your employer’s plan.13. Does my employer have to provide health insurance?In 2015, employers with 100 or more full-time employees will be required to offer health insuranceto full-time employees and their dependents (but not to part-time employees). If they don’t, theywill have to pay a tax. Starting in 2016, the same type of requirement will apply to employers with50-99 full-time employees (they will also be required to offer health insurance to their full-timeemployees and their dependents). This rule won’t apply to employers with fewer than 50 full-timeemployees.

The complete What You Need to Know about Health Insurance series:Applying for Health InsuranceAnswering Questions about Your Family When Applying for Health InsuranceAnswering Questions about Your Family’s Income When Applying for Health InsuranceApplying for a Marketplace Plan if You Can Get Health Insurance through Your JobWhat to Do if You Are Uninsured after February 15, 2015Getting Financial AssistanceGetting Financial Assistance to Pay for Health InsuranceDeciding How Much Financial Assistance to Use to Lower Your Monthly PremiumsWill I Be Able to Get Financial Help to Pay for Health Insurance?How Getting Financial Assistance to Pay for Health Insurance Affects Your TaxesGetting Extra Financial Assistance to Help Pay Health Care CostsChoosing a Health PlanChoosing the Health Plan that’s Right for YouChoosing a Health Plan You Can AffordUnderstanding the Differences between Platinum, Gold, Silver, and Bronze PlansUnderstanding Catastrophic Health InsuranceBuying Children’s Dental Coverage through the MarketplaceKeeping and Using Health InsuranceHow to Use Your Health InsuranceHow to Keep Your Marketplace Health InsuranceWhat to Do after You Buy Health Insurance in the MarketplaceUnderstanding the Requirement to Have Health InsuranceUnderstanding the Requirement to Have Health InsuranceUnderstanding Minimum Essential CoverageReference Charts and GraphicsIncome Guidelines for Getting and Using Financial Assistance for Health InsuranceIncome Guidelines for Getting Extra Financial Assistance to Pay for Health Care CostsTypes of Exemptions from the Requirement to Have Health InsuranceA complete list of Families USA publications is availableonline at www.FamiliesUSA.org/resources/publications.PUBLICATION ID: 001NAV0929151201 New York Avenue NW, Suite 1100 [email protected] | www.FamiliesUSA.org Washington, DC 20005 © Families USA 2015 202-628-3030



INCARCERATION AND THE MARKETPLACE Frequently Asked QuestionsSection 1312(f)(1)(B ) of the Affordable Care Act and 45 CFR 155.305(a)(2) provide that an individual isnot eligible to enroll in a Qualified Health Plan (QHP) through the Health Insurance Marketplace if he orshe is incarcerated, other than incarceration pending the disposition of charges. These FAQs provideguidance on the definition of “incarcerated,” and “incarceration pending the disposition of charges” forthe purposes of eligibility for enrollment in a QHP through the Marketplace.The information in this document applies to all Federally-facilitated Marketplaces (including StatePartnership Marketplaces), and to State-based Marketplaces that rely on the federal eligibility andenrollment platform. State-based Marketplaces that do not rely on the federal eligibility and enrollmentplatform may adopt the policies set forth in this document, or other reasonable ones consistent withapplicable law.The information in this document does not apply to eligibility for Medicaid or the Children’s HealthInsurance Program (CHIP).Q1. What is the definition of incarcerated (other than incarcerated pending the disposition ofcharges) for enrolling in a qualified health plan (QHP) through the Marketplace?A. For purposes of eligibility for enrollment in a QHP through the Marketplace, the Federally-facilitatedMarketplace (FFM) considers an individual incarcerated if the individual has been convicted of a crimeand is sentenced to confinement in an institution such as a correctional facility or inpatient mentalhealth facility. An individual will also be considered incarcerated if the individual is currently an escapeefrom confinement or has had his or her parole and/or probation revoked and is sentenced toconfinement in a correctional institution.The FFM will not consider an individual incarcerated if the individual: (1) has not been convicted of acrime, (2) has been convicted of a crime but is not currently sentenced to confinement in an institution,or (3) has been convicted of a crime and is sentenced to a partial, limited, or alternative form ofconfinement, but no government entity is required to provide the individual with medical care. Forexample, the Marketplace may find that an individual in the following situations is considered notincarcerated: • Living in the community after a sentence has been served; • On probation or parole; or • Any of the following if no county, city, state, or federal government is required to pay for or provide for the individual’s medical care: o Serving a sentence but allowed work release, o Under house arrest or home confinement, or o Residing in a halfway house or other similar type of residential community supervision as a result of a conviction 1

The precise application of these standards may vary by jurisdiction, because of differing terminology forthese concepts across jurisdictions.Q2. What does “incarceration pending the disposition of charges” mean?A. For purposes of eligibility for enrollment in a QHP through the Marketplace, the FFM considers anindividual incarcerated pending disposition of charges if the individual has been charged with a crimebut is waiting for the outcome of the charges to be determined. This includes situations in which anindividual is: • Arrested but not convicted of a crime; and • Convicted of a crime but awaiting sentencing, whether confined to a correctional institution or released on bail, bond, or other conditional release.An individual who is incarcerated pending disposition of charges can enroll or continue existingenrollment in a QHP through the Marketplace and receive advance payments of the premium tax creditand cost-sharing reductions if he or she meets the other eligibility requirements.Q3. Are probationers and parolees considered incarcerated if they are sent back to jail because theirprobation or parole has been revoked?A. Probationers and parolees can be eligible to enroll or stay enrolled in a QHP through the Marketplaceif they are in a prison or jail pending the results of a hearing to determine if their probation or parole willbe revoked. If they are sentenced to confinement in an institution because their probation or parole hasbeen revoked, they are no longer eligible to enroll in a QHP through the Marketplace, and, if alreadyenrolled, must report the change in their status within 30 days so their QHP coverage through theMarketplace can be terminated.Q4. If an individual enrolled in Marketplace coverage is sentenced to serve time in prison or jail, mustthe individual report that change to the Marketplace and terminate coverage through theMarketplace?A. Yes. Enrolled individuals have 30 days to report a change that affects their eligibility for enrollment ina QHP through the Marketplace, including incarceration (other than incarceration pending disposition ofcharges).In general, changes in eligibility can be reported by the enrollee or application filer, within 30 days, bycontacting the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) or by visitingHealthCare.gov. Changes can also be reported through the Marketplace Call Center by (1) any adult age18 or over who is on the application and applied for Marketplace coverage, or (2) an adult age 18 orover listed as a tax filer on the incarcerated individual’s application for Marketplace coverage, even ifthe tax filer didn’t apply for coverage. Instructions on reporting a change and ending Marketplacecoverage using HealthCare.gov are available at www.healthcare.gov/reporting-changes/cancel-plan/. 2

If neither the incarcerated individual nor any adult on the application is able to contact theMarketplace to report a change and end Marketplace coverage, then an individual authorized tocontact the Marketplace on the incarcerated individual’s behalf can call the Marketplace Call Centerat 1-800-318-2596 (TTY: 1-855-889-4325).Changes may not be reported by mail or through the paper application. 3



GUIDE TO SPECIAL ENROLLMENTThe Marketplace open enrollment period is the regular time each year when peMarketplace (also known as an exchange). But certain events that occur duringable to newly enroll in a Marketplace plan or change to a different plan.This chart is a reference tool for those who are helping people enroll in health c• The chart focuses on the circumstances that trigger a SEP in the Marketplac reductions if they enroll through the Marketplace.) Except where specified, whether the Marketplace is operated by the federal government or the state enrollment opportunities.• Although the chart focuses on coverage in the Marketplace, most of the SEP insurance market outside of the Marketplace. The exceptions are those rela• An individual generally has 60 days from the triggering event to select a pla coverage, a person also has 60 days prior to the event to select a plan. This c a gap in coverage.• Many SEPs are available when a “qualified individual” or that person’s depen available only when an “enrollee” or the dependent of an enrollee experienc qualified individuals and which SEPs are only available to enrollees or their d

T PERIOD TRIGGERS AND TIMINGeople can newly enroll in a plan or change to a different plan through theg the year can trigger a special enrollment period (SEP), when a person may becoverage. Users of the chart should know:ce. (People can only obtain federal premium tax credits and cost-sharing, the SEP triggering events listed in the chart apply in all states, regardless of e. States or State-Based Marketplaces (SBMs) may create additional specialP triggering events listed in the chart also apply to the individual healthated to citizenship status, Indian status, and exceptional circumstances.an before the SEP ends. For some triggering events such as losing other can help people set up health coverage ahead of time so they don’t experiencendent (for SEP purposes) experiences the triggering event. Other SEPs areces the triggering event. The chart separates which SEPs are available to dependents. Updated March 2016

DEFINITIONS FORQualified Individual: Someone who meets the criteria to enroll through the Mathe state where the Marketplace operates), and includes individuals already enroDependent: Someone eligible to enroll in a health plan with a qualified individudoes not have to be a tax dependent.)Enrollee: Someone enrolled in a QHP through the Marketplace.Triggering Event: An event that allows a person to newly enroll in a Marketplactriggering events allow someone to newly enroll in a Marketplace plan. Some onRegular coverage effective dates: Coverage is effective the first day of the follosecond following month if plan selected between the 16th and the last day of thChart Key: = Enrollee; = Dependent(s) for SEP purposes = Qualified individual; How to use the SE Scenario: Consumer’s husband loses his job, causi The consumer, her husband and1 Triggering event? Loss of eligibility for employer coverage 3 Who can use SEP? Husband (qualified individua 2

R SEP PURPOSESarketplace (i.e., not being incarcerated, being lawfully present, and residing inolled in a qualified health plan (QHP) through the Marketplace.ual under the terms of the health plan. (NOTE: The dependent for SEP purposesce plan or change to a different plan outside of open enrollment. (NOTE: Not allnly allow people who are already enrolled to change plans.)owing month if plan is selected between the 1st and 15th, or the first day of thehe month. s; = Dependent(s) for SEP purposes enrolled in the same QHP as enrolleeEP reference charting him to lose his employer-sponsored insurance.d their daughter need coverage. 2 Who triggers SEP? Husband (the qualified individual)al), wife and daughter (dependents for SEP purposes) 13 Page 2

SEPs Available Regardless of Whether a Person isSEP Triggering Who Can Details / ExamplesEvent Trigger SEPGaining or Marriagebecoming adependent Birth, Adoption, Placement for Foster Care or Adop • Includes gaining a dependent through a child sup other court orderGaining eligible • Becoming a U.S. citizen, U.S. national, or gaining laimmigration status statusPermanent move Note: For a list of “lawfully present” immigration statuses eligible fLoss of MinimumEssential Coverage coverage, see Healthcare.gov: www.healthcare.gov/immigrants/im(MEC) • Move within the same city, county, or state as long different set of qualified health plans available • Move to another state • Return to the U.S. after living outside the country • A child or other dependent moves back to parent’ • Released from incarceration • Move for seasonal employment, but maintain ano elsewhere (such as a seasonal farmworker) Note: This SEP cannot be used for a short-term or temporary info, see these FAQs from the Marketplace. • Loss of eligibility for employer coverage (e.g., loss voluntarily quiting a job, or a reduction in work ho loss of availability of employer-sponsored plan) • Loss of Medicaid or CHIP eligibility (including loss related and medically needy Medicaid) • Expiration of COBRA • Cancellation of non-group plan • Loss of eligibility for student health plan • Divorce or legal separation resulting in loss of cov • Cessation of dependent status • Death (i.e., of another person in the family) resulti coverage • Decertification of current Marketplace coverage • No longer living, working, or residing in the area o • Termination of employer contributions to employ coverage • Newly eligible for the premium tax credit due to d or change to employer-sponsored plan resulting i being considered MEC Note: “Loss” does not include voluntary termination of cover by the insurer due to nonpayment of premiums

Already Enrolled in a Qualified Health Plan (QHP) Who Can Timing of SEP Coverage Effective Dates Use SEP Up to 60 days after 1st day of month following plan date of marriage selection ption Up to 60 days after Date of birth, adoption orpport order or birth, adoption or placement, or effective date of placement court order (MARKETPLACE OPTION: may awfully present allow consumers to choose effective for Marketplace date of 1st day of month after date ofmmigration-status birth, adoption, placement, etc.) g as there is a Up to 60 days after Regular coverage effective dates gaining status ’s homeother home Up to 60 days after Regular coverage effective dates permanent movey move. For more MARKETPLACE OPTION: IF PLAN SELECTED BEFORE DATE OF of a job,ours that causes 60 days before MOVE: 1st day of month followings of pregnancy- permanent move permanent moveverageing in loss of Mandatory for IF PLAN SELECTED AFTER DATE OF Marketplaces to offer starting Jan. 1, MOVE: Regular coverage effective 2017 dates (MARKETPLACE OPTION: 1st day of month following plan selection) Up to 60 days IF PLAN SELECTED BEFORE OR ON DATE before and 60 days after date of loss OF LOSS OF COVERAGE: 1st day of of coverage month following loss of previous coverage IF PLAN SELECTED AFTER DATE OF LOSS OF COVERAGE: 1st day of the month following plan selection (MARKETPLACE OPTION: regular coverage effective dates)of the planyee’s healthdiscontinuationin plan no longer rage or termination Page 3

SEPs Available Regardless of Whether a Person isSEP Triggering Who Can Details / ExamplesEvent Trigger SEPMoving out of the • Income increases to a level above 100% of the povMedicaid coverage creating eligibility for premium tax creditsgap • Applies only to residents of states that did not expExpiration of non-calendar year plan • The plan year ends for a non-calendar year plan in (non-group) or group market (i.e., the plan year en other than December) • Applies even if there is an option to renew the non planExceptional • Demonstrate to the Marketplace that an individuacircumstances exceptional circumstancesError/inaction/ • Serious medical condition or natural disaster keptmisconduct from enrolling during open enrollment (e.g., unex hospitalization or temporary cognitive disability; aStatus as American hurricane, or massive flooding)Indian and AlaskaNative • Survivors of domestic violence or abuse or spousaKey: = Qualified individual; • Medicaid/Marketplace transfers that kept a person in coverage during open enrollment • System errors related to immigration status • Unresolved casework that kept a person from enro coverage during open enrollment Note: Many complex situations may trigger an SEP under ex circumstances. For more information on this SEP and how to Healthcare.gov: www.healthcare.gov/sep-list • Error, misrepresentation, or inaction by the Marke instrumentalities, or other entity providing enrollm (e.g., assisters, navigators, insurers, brokers) resulte not being enrolled in a plan, being enrolled in the not receiving advance payments of premium tax c sharing reductions for which the person was eligib Note: For more information on this SEP and how to access it, gov: www.healthcare.gov/sep-list • Is or becomes a member of a federally recognized American or Native Alaskan tribe = Dependent(s) for SEP purposes

Already Enrolled in a Qualified Health Plan (QHP) Who Can Timing of SEP Coverage Effective Dates Use SEPverty line Up to 60 days after Regular coverage effective dates change in incomepand Medicaid Up to 60 days IF PLAN SELECTED BEFORE OR ON DATE before and 60 daysn the individual after date of loss OF LOSS OF COVERAGE: 1st day ofnds in a month of coverage month following loss of previous coveragen-calendar year IF PLAN SELECTED AFTER DATE OF LOSS OF COVERAGE: 1st day of the month following plan selection (MARKETPLACE OPTION: regular coverage effective dates)al meets Up to 60 days after Effective date appropriate to triggering event circumstancest personxpectedan earthquake,al abandonmentn from enrolling olling in Up to 60 days after Effective date appropriate to triggering event circumstancesxceptionalo access it, see May enroll in or Regular coverage effective dates change QHPs oneetplace or HHS, its time per monthment assistance ed in the persone wrong plan, orcredits or cost- ble , see Healthcare.d Native Page 4

SEPs Available to People Already EnroSEP Triggering Who Can Details / ExamplesEvent Trigger SEPLosing a dependent Death (optional for Marketplaces)or no longer • Enrollee or enrollee’s dependent diesconsidered adependent Divorce or legal separation (optional for Marketpla • Loses a dependent due to divorce or legal separatNewly eligible or • No longer considered a dependent due to divorceineligible for PTCs • Includes losing dependent through a child suppoChange in cost- court ordersharing reduction(CSR) eligibility • Change in income or household size leads to dete enrollee or dependent is newly eligible or ineligibHealth plan tax creditsviolation • Change in income or household size changes elig sharing reductions • Includes moving between cost-sharing reduction or gaining eligibility • Demonstrate to the Marketplace that QHP substan material provision of its contractKey: = Enrollee; = Dependent(s) for SEP purposes; = Dependent(s) for SE

olled in a QHP (and their dependents) Who Can Timing of SEP Coverage Effective Dates Use SEP Up to 60 days after 1st day of month following planaces) tion death selection (MARKETPLACE OPTION: regulare or separationort order or other coverage effective dates) Up to 60 days after Regular coverage effective dates divorce or legal separationermination that Up to 60 days after Regular coverage effective datesble for premium determinationgibility for cost- Up to 60 days after Regular coverage effective dates levels and losing determinationntially violated a Up to 60 days after Effective date appropriate to triggering event circumstancesEP purposes enrolled in the same QHP as enrollee Page 5





Special Enrollment Periods for theHealth Insurance MarketplaceA Special Enrollment Period may allow you to enroll in a Marketplace plan outside of the annual OpenEnrollment Period if you experience a qualifying event. You may qualify for a Special Enrollment Period inthese situations:Situation Details 1. Loss of qualifying health You may qualify for a Special Enrollment Period if you (or anyone in your coverage household) lost qualifying health coverage. Some examples of qualifying coverage include: 2. Change in household size • Coverage through a job, or through another person’s job. » This also applies if you’re now eligible for help paying for coverage because your employer stops offering coverage or the coverage isn’t considered qualifying coverage. • Medicaid or Children’s Health Insurance Program (CHIP) coverage (including pregnancy-related coverage and medically needy coverage). • Medicare. • Individual or group health plan coverage that ends during the year. • Coverage under your parent’s health plan (if you’re on it). If you turn 26 or the maximum dependent age allowed in your state and lose coverage, you can qualify for this Special Enrollment Period. Note: This doesn’t include loss of coverage because you didn’t pay your premiums. You may qualify for a Special Enrollment Period if you (or anyone in your household): • Got married. • Had a baby, adopted a child, or placed a child for foster care. • Got divorced, legally separated, or had a death in the family and lost health coverage. • Gained or became a dependent due to a child support or other court order.

Situation Details 3. Change in primary place of You may qualify for a Special Enrollment Period if you (or anyone in your living household) have a change in your primary place of living and gain access to new qualified health plans as a result. This includes: • Moving to a new home in a new ZIP code or county. • Moving to the U.S. from a foreign country or United States territory. • A student moving to or from the place he or she attends school. • A seasonal worker moving to or from the place he or she lives and works. • Moving to or from a shelter or other transitional housing. Note: Starting July 2016, you must prove you had qualifying health coverage for one or more days in the 60 days before your move, unless you’re moving from a foreign country or United States territory. Also, moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.4. Change in eligibility for You may qualify for a Special Enrollment Period if you (or anyone in your Marketplace coverage or household): help paying for coverage • Are enrolled in Marketplace coverage and report a change that makes you: » Newly eligible for help paying for coverage. » Ineligible for help paying for coverage. » Eligible for a different amount of help paying for out-of-pocket costs, like copayments. • Become newly eligible for Marketplace coverage because you’ve become a U.S. citizen, U.S. national, or lawfully present individual. • Become newly eligible for Marketplace coverage after being released from incarceration (detention, jail, or prison). • Gain or maintain status as a member of a federally recognized tribe or Alaska Native Claim Settlement Act (ANCSA) Corporation shareholders (you can change plans once per month). • Become newly eligible for help paying for Marketplace coverage because you had a change in household income or moved to a different state and you were previously both of these: » Ineligible for Medicaid coverage because you lived in a state that hasn’t expanded Medicaid. » Ineligible for help paying for coverage because your household income was below 100% of the Federal Poverty Level (FPL).

Situation Details 5. Enrollment or plan error Although these are less common, you may qualify for a Special Enrollment Period6. Other qualifying changes if you (or anyone in your household): • Weren’t enrolled in a plan or were enrolled in the wrong plan because of: » Misinformation, misrepresentation, misconduct, or inaction of someone working in an official capacity to help you enroll (like an insurance company, navigator, certified application counselor, agent, or broker). » A technical error or another Marketplace-related enrollment delay. » The wrong plan data (like benefit or cost-sharing information) was displayed on HealthCare.gov at the time that you selected your health plan. • Can your Marketplace plan has violated a key part (called a “material provision”) of its contract. You may qualify for a Special Enrollment Period if you (or anyone in your household): • Applied for Medicaid or Children’s Health Insurance Program (CHIP) coverage during the Marketplace Open Enrollment Period, or after a qualifying life event, and your state Medicaid or CHIP agency determined you or they weren’t eligible. • Are a victim of domestic abuse or spousal abandonment and want to enroll in a health plan separate from your abuser or abandoner. • Are an AmeriCorps service member starting or ending AmeriCorps service. • Can show you had an exceptional circumstance that kept you from enrolling in coverage, like being incapacitated or a victim of a natural disaster.What if I think I qualify for a Special Enrollment Period?Visit HealthCare.gov and answer a few questions to find out if you qualify for a Special Enrollment Period toenroll in or change plans. , you’ll also find out if you for coveragethrough Medicaid or CHIP. We’ll tell you when your coverage will start and your next steps.You can also call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to enroll by phone.Be sure to tell the representative you think you qualify for a Special Enrollment Period. They’ll verify whetheryou do.Important: When you apply, you must attest that the information you provide on the application is true,including the facts that qualify you for a Special Enrollment Period. You may be asked to provide documentsthat prove your eligibility to enroll.Note: If you’re applying for health coverage in a state running its own Marketplace, your state mayhave other Special Enrollment Periods than those listed here. Visit HealthCare.gov to find your state’sMarketplace. CMS Product No.11794 Revised May 2016



COVERAGE GAP SEP:A consumer may qualify for the Medicaid Coverage Gap Special Enrollment Period(SEP) if the consumer meets all of the Resides in a non-Medicaid expansion state; Was previously ineligible for advance payments of the premium tax credit (APTC)solely because of a household income below 100% of the Federal Poverty Level; Was ineligible for Medicaid during that same timeframe; and Has experienced a change in household income that makes him/her newly eligiblefor APTC.In April 2015, CMS removed the requirement for consumers to receive thefollowing documents before applying for Marketplace coverage through thisSEP: a Medicaid denial notice from their state Medicaid agency, an ExemptionCertificate Number (ECN), or a Marketplace Eligibility Determination Notice thatshows they weren’t eligible for APTC.Update: Within the last year, the process for requesting this SEP has changed. Aconsumer who believes he or she is eligible for this SEP should: Complete a Marketplace application online at HealthCare.gov or by calling theMarketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to determine ifhe or she is eligible for APTC. Call the Marketplace Call Center or let the Call Center representative know thats/he was previously ineligible for Medicaid because s/he lives in a non-Medicaidexpansion state, and was previously ineligible for APTC because his or her incomewas too low, but has now experienced an increase in household income that makeshim or her newly eligible for APTC. Once the Call Center Representative confirms that the consumer is eligible forAPTC, s/he will forward the consumer’s application to the Marketplace to determineSEP eligibility. Reviews should be completed within 15 calendar days or 10business days.The consumer should expect a letter within a few days after that. If the consumer is eligible for this SEP, the letter will instruct the consumer toreturn to his or her Marketplace application or call the Marketplace Call Center tocomplete the enrollment process. If the consumer is not eligible for this SEP, theconsumer must wait until the next OE Period or upon qualifying for a different SEPto enroll in coverage.

Important reminders about this SEP: The consumer only has 60 days from the date that s/he experienced the change inhousehold income that made him or her newly eligible for APTC to call theMarketplace to report this change and request this SEP. A consumer is only eligible for this SEP if s/he lives in a non-Medicaid expansionstate. A consumer is only eligible for this SEP if his/her household income was previouslybelow 100% of the FPL and s/he recently experienced an increase in householdincome that now makes him/her eligible for APTCs. An increase in income alone will not automatically make a consumer eligible forAPTC. There are other reasons why a consumer may not be eligible for APTC, suchas already having access to other Minimum Essential Coverage. A consumer mustbe determined eligible for APTC in order to qualify for this SEP. This SEP is not available online, so, although the consumer is encouraged tocomplete a Marketplace application online, he or she must also call the MarketplaceCall Center after completing the application to request this SEP. The consumer alsohas the option to complete the Marketplace application when s/he calls theMarketplace Call Center.FUTURE OPEN ENROLLMENT PERIODS:CMS finalized the OE Periods for future years: 2017 & 2018 coverage: OE will begin on November 1 of the previous yr. & runthrough January 31 of the coverage year. 2019 coverage & beyond:OE will begin on November 1 and end on December 15 of the preceding yr. (forexample, November 1, 2018 through December 15, 2018 for 2019 coverage).

Enrollment Materials



Model Navigator Assistance Consent Form in Federally-Facilitated or State Partnership Marketplaces (Marketplace) Cover SheetTo be sure you are making an informed decision to provide your personal information to [Name] to help youwith understanding your health coverage options and completing an application for health coverage throughthe Marketplace, [Name] should talk with you about the following things before asking you to sign theConsent Form giving your permission for help. 1. [Name] will help me, to the best of their ability, as I learn about my health coverage options. 2. [Name]will not choose a health plan for me. 3. [Name]will keep my personal information private and secure. 4. [Name]should not store my personal information except for limited reasons, such as taking my [Name] and phone number when arranging for an appointment for me to meet with a Navigator, or keeping a copy of my Consent Form. [Name] will make sure that any stored information is kept private and secure. 5. [Name]will need to see and use my personal information in order to do their job as a Navigator and help me in applying for health coverage. 6. [Name] should not keep anything with my personal information included on it after our meeting is over, other than a copy of my Consent Form. 7. [Name] is required to have knowledge about health insurance available in the Marketplace, as well as other health coverage like Medicaid and CHIP. 8. I understand that nothing requires me to share information with [Name]. 9. [Name]will help me based on the information that I provide. 10. [Name] will help me understand my health insurance options in the language I speak/understand, or will refer me to other assistance that is able to provide information in the language I speak/understand. 11. [Name] should not charge me any money for helping me. 12. [Name] will provide me with a copy of my Consent Form and this Cover Sheet, once complete. 13. I can cancel my consent at any time.* NOTE TO NAVIGATOR ORGANIZATION AND INDIVIDUAL NAVIGATOR: Each time [Name] appears in thisConsent Form, the name of the Navigator Organization and the name of the individual staff/volunteerNavigator should be inserted instead of [Name]. 1

Model Navigator Assistance Consent Form for Navigators in Federally Facilitated Marketplace or State Partnership Marketplaces (Marketplace)Navigator Organization: Primary Care Access NetworkNavigator Organization Address: 101 S. Westmoreland, Drive, Orlando, FL 32805Navigator Organization Phone Number and E-mail Address: __1-877-564-5031 [email protected]_____Individual Navigator: [Name]Certification Number: __________________ Florida License: ___________I, ______________________, give my permission, or ________________________, my legal or Marketplaceauthorized representative acting on my behalf (“authorized representative”), gives his/her permission to [Name] toinform me and/or my authorized representative about my health coverage options in the Marketplace to help meapply for and enroll in health coverage through the Marketplace if I choose to do so, and/or to help with agrievance, complaint, or question about my health plan, coverage, or a determination under such a plan orcoverage. I understand that in giving this consent, that [Name] will need to see or use some of my personallyidentifiable information in order to provide this assistance.In this consent form: • whenever it says “me” or “my”, “me” or “my” includes my authorized representative if I have one. • personally identifiable information is called “PII.” • health plans available through the Marketplace are called Qualified Health Plans or “QHPs”.I understand that: [Name] will help me to the best of his or her ability by telling me about the full range of QHP options and insurance affordability programs for which I may be eligible, and will help me with grievances, complaints, or questions about my health plan, coverage, or a determination under such a plan or coverage, if I want that help. [Name] can’t choose a health insurance plan for me. [Name] will make sure that my PII is kept private and secure when creating, collecting, disclosing, accessing, maintaining, storing, and/or using my PII and/or the PII of my authorized representative. [Name] should not maintain or store any of my PII and/or the PII of my authorized representative, other than this consent form, as a result of carrying out the duties of a Navigator. The duties of a Navigator are explained below. [Name] will make sure that any stored PII is kept private and secure. [Name] may create, collect, disclose, access, maintain, store, and/or use my PII, and/or the PII of my authorized representative, only in order to perform the duties of a Navigator, and may not re-use that PII for any other purposes1. The duties of a Navigator include:1 The duties of a Navigator in the Federally-facilitated and State Partnership Marketplaces are stated in: section 1311(i)(3)of the Affordable Care Act; 45 CFR 155.210(e); 45 CFR 155.215(a)(1)(iii); the Cooperative Agreement to SupportNavigators in Federally-facilitated and State Partnership Exchanges funding opportunity announcement (“NavigatorFOA”); and the Notice of Award under the Navigator FOA. 2

o Providing information and services in a fair, accurate, and impartial manner. This information should include information about the full range of QHPs that are available and also other health programs like Medicaid and CHIP. The information must be provided in a way that is culturally and linguistically appropriate to the needs of the population being served by the Marketplace, including individuals with limited English. o Ensuring that Navigator tools and functions are accessible and usable for individuals with disabilities. o Facilitating the selection of a QHP. o Providing referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies, for any enrollee with a grievance, complaint, or question about his or her health plan, coverage, or a determination made under such plan or coverage. [Name] must also maintain expertise in eligibility, enrollment, and program specifications for QHPs and insurance affordability programs, and conduct public education activities to raise awareness about the Marketplace. [Name] should not need to collect, handle, disclose, access, maintain, store and/or use my PII, and/or the PII of my authorized representative for these functions. If [Name] does collect, handle, disclose, access, maintain, store and/or use my PII, and/or the PII of my authorized representative, for this function, [Name] will keep that PII private and secure. I and/or my authorized representative don’t have to provide [Name]with more information than I and/or my authorized representative choose to provide. The help [Name] provides is based only on the information I or my authorized representative provide, and if the information given is inaccurate or incomplete, [Name] may not be able to offer all the help that is available for my situation. If [Name] can’t help me due to a lack of translation services, lack of expertise, or some other barrier, he or she will refer me to another Navigator or in-person assistance personnel, or the federal Marketplace Call Center, who can meet my specific needs. CMS expects that [Name] will not charge me a fee for any help provided.I may cancel my consent in writing at any time and will notify [Name] if I choose to cancel my consent. I understandthat once I have signed this consent form, I can expect [Name] to help me without asking me to sign anotherconsent form. Please sign and date the form:_____________________________________________________________________________Consumer/Consumer’s Legal or Marketplace Authorized Representative Signature(Please also circle one of these to show if you are the consumer or the consumer’s representative.)DatePLEASE NOTE: Consumers may sign this consent form themselves, or may choose to have a legal guardian,personal representative, or other delegated representative sign it. 3



Worksheet: What income should I list Amount on my health insurance application? $Income You Should Include $ $Wages (gross income before taxes), tips, bonuses, back pay $ $Pensions and other retirement income (including IRA and annuity distributions) $Unemployment insuranceEducational scholarships used to pay for room, board, and other living $expensesEducational scholarships used to pay for tuition and required fees, books, $supplies, and equipment—if you choose to report scholarship income in order $to qualify for education tax credits $ $Investment income (interest earned on an account) $Rental or royalty income $Alimony received $Taxable interest or dividends (usually, interest you get from bank accounts, $bonds, or other shared accounts)Tax-exempt interest (usually, interest that is paid on a bond) $Taxable refunds, credits, or o sets of state and local income taxes (if you $itemized, or if you chose to deduct state or local income taxes instead of $general sales taxes)Income earned overseasOther income (such as gambling prizes or awards)Total Income You Should Include continue on other side

Answering Questions aboutYour Family’s Income When Applying for Health InsuranceIncome You Should Not Include AmountSupplemental Security Income (SSI) $ $Child support received (child support counts as income for the payer) $ $Workers’ compensation $ $Temporary Assistance for Needy Families (TANF) and other government cash $assistance $ $Supplemental Nutrition Assistance Program funds (SNAP, formerly known as $food stamps) $ $Inheritance $Payments from an insurance settlement (continued)Payments from a state, political subdivision, or foster care agency for providingcare to foster children (unless you care for more than 5 individuals age 19 orolder or 10 individuals under age 19)Federal tax credits and federal income tax refundsGifts and loansIncome you deduct on your taxes: Student loan interest: $___________ Tuition and fees: $___________ Educational scholarships used to pay for tuition and required fees, books, supplies, and equipment—if you do not choose to report scholarship income in order to qualify for educational tax credits: $___________ Educator expenses: $___________ Contributions to a retirement account: $___________ Moving expenses related to a job change: $___________ Penalties on early withdrawal of savings: $___________ Contributions to a health savings account: $___________ Alimony paid: $___________ Costs for domestic production activities: $___________ Certain business expenses for reservists, performing artists, Certain self-employment expenses: $___________Total Income You Should Not IncludeWHAT YOU NEED TO KNOW ABOUT HEALTH INSURANCE

HEALTHCARE.GOV APPLICATION SIGN-IN INFORMATION AND PLAN DETAILS Date of Initial Appointment: _______________________________Email Address: ___________________________________________________________________________________________Email Password: _________________________________________________________________________________________Healthcare.gov User ID: _______________________________________________________________________________Healthcare.gov Password: ____________________________________________________________________________Security Question # 1 _________________________________________ Response: ______________________________Security Question # 2 _________________________________________ Response: ______________________________Security Question # 3 _________________________________________ Response: ______________________________Security Question # 4 _________________________________________ Response: ______________________________Application ID: ___________________________________________________________________________________________Health Plan Selected: _____________________________________________________________________________________Plan Phone Number: _____________________________________________________________________________________Plan Monthly Premium: ________________________Premium Tax Credit Amount: ______________________Plan 1st Payment Due Date: _____________________________________________________________________________Dental Plan Selected: ____________________________________________Monthly Premium: __________________Dental Plan Phone Number: ____________________________________________________________________________AFTER YOU HAVE ENROLLED After about 3 business days, call your insurance company to make sure they have received your information from the Marketplace Set up a payment system and confirm the date your coverage begins Call your primary care provider to set up your first appointment if you’re a new patient Pay close attention to all written documents that come from healthcare.gov or the IRSUpdate your account information during the year if: 1) Your income changes (higher or lower) 2) You change jobs or you get a job which offers health insurance 3) Your household size changes (because of marriage, divorce, children, etc.) Central Florida Navigators: 1-877-564-5031 * CoveringCFL.net or Dial 2-1-1 Healthcare.gov 1-800-318-2596 * Live Operators 24hrs/day, 7 days a week



Pick 3 questions & write the re

esponse on the designated line.

Escoja 3 preguntas y escriba la

respuesta en la línea designada.

Marketplace Plan Comparison Worksheet Applicant Name: __________________________ Tax Credit (monthly): ____________ Date: ___________ Number of people in the plan: _____ Eligible for cost-sharing reductions? No 73% 87% 94% Option 1 (or Current Plan) Option 2 Option 3Insurance companyHealth plan nameMetal tier (Bronze, Silver, Gold, Platinum)Plan type (HMO, PPO, POS, EPO, or other)PrescriptionsMonthly premium (after tax credit) Amount Amount Amount Deductible (medical/drug or combined) Deductible applies? (check if yes) Deductible applies? (check if yes) Deductible applies? (check if yes) (If family deductible: aggregated or embedded?) In Network/Covered? In Network/Covered? In Network/Covered? Out-of-Pocket Maximum (OOP Max) Copays/Coinsurance Primary Care Provider (PCP) visit Specialist visit Generic drugs Preferred brand name drugs Non-preferred brand name drugs Specialty drugs Emergency Room (ER) visit Inpatient hospital stay Other service: Other service: Other service: Health Care Providers Current doctor/provider:Other provider or hospital:Current prescription drugs: Other ConsiderationsOther consideration:Other consideration:Other consideration: Questions, comments or feedback? Please contact Dave Chandra, [email protected] (as of October, 2015)

How to use the Marketplace Plan Comparison WorksheetThe Marketplace Plan Comparison Worksheet is a tool intended for Marketplace enrollment assisters(i.e. navigators, In-Person Assisters, Certified Application Counselors) when helping consumers with theprocess of comparing Marketplace Qualified Health Plans and selecting the plan that best meets theirneeds.The Worksheet allows you to compare up to three Marketplace Qualified Health Plans side-by-side on anumber of different features. Some consumers may be returning clients who currently have aMarketplace plan and are seeking help with renewal; in these cases, it may be useful to include theclient’s Current Plan in the first column marked Option 1 so that the consumer can compare the 2016options with what he or she currently has.As you and your client review health plans on healthcare.gov or other Marketplace websites, you canwrite down and compare the different features of each health plan, including:The insurance company name, insurance plan name, metal tier of the plan, and plan type (HMO,PPO, POS, etc).The insurance plan’s monthly premium (after the tax credit is applied).The deductible amount (which is the amount a consumer must pay themselves before the planbegins to start paying for services and the consumer only has to pay the copay or coinsurance).The plan may have separate values for a medical deductible and a drug deductible, or onecombined deductible. If it is a family plan, you can note whether it is an aggregate or embeddeddeductible.The out-of-pocket maximum (which is the maximum amount that a consumer would be required topay in cost-sharing expenses at in-network providers in a given year. Once a consumer reachesthis amount, the plan will pay for all other in-network expenses for the rest of the year).Copays and coinsurance amounts for commonly used services, such NOTE: if the plan covers out-of-visits to the primary care provider, specialist, emergency room, network providers, you caninpatient hospitalization as well as for filling a prescription for a note the out-of-network copay/generic, preferred brand name, non-preferred brand name, or coinsurance in the same box.specialty medication. Be sure to note whether or not the deductible For example: specialist visitapplies to that service by checking the corresponding gray box. with in-network copay of $10 and out-of-networkCopay/coinsurance information for up to three more coinsurance of 50% could bebenefits/services based on the consumer’s interests and health listed as $10/50%.care needs in the rows marked “Other service.”Whether or not the consumer’s current doctor(s) or preferred hospital or hospital network are inthe plan’s network.Whether or not the consumer’s prescription medication is covered on the plan’s formulary, andwhich drug tier it is listed under (generic, preferred brand name, non-preferred brand name, orspecialty).Other considerations: any other considerations that are important to the consumer, for example,whether or not each plan includes coverage for pediatric dental care or chiropractic services, orhow many providers are in network near the consumer’s zip code that speak the consumer’spreferred language, or what the limit is on the number of visits allowed for physical therapy.

Que Usted debe traer a su cita con un navegador Nombre de usuario y contraseña para el Mercado—este fue el documento que le entregó el navegador cuando se inscribió. Si lo ha perdido por favor traiga su contraseña del correo electrónico (o tenga acceso fácil a su correo electrónico para restablecer la contraseña) Si esta es su primera vez aplicando, le ayudaremos a crear uno para usted. Declaración de Impuestos del 2015 y/o los últimos talonarios de pago (para ayudar a estimar ingresos de 2016/2017) Si esta es su primera vez aplicando, todos los miembros del hogar que se presentan en la misma aplicación se deben incluir en su declaración de impuestos doméstico. Números de seguro social de los nuevos miembros de su hogar. Si esta es su primera vez aplicando, necesitamos nombre, fecha de nacimiento y números de seguro social para todos los miembros del hogar. Información sobre cobertura médica ofrecida por el empleador de cualquier persona en su hogar para el año 2016/2017. Números de documentos para todos los inmigrantes legales en su hogar (es decir pasaporte, residencia permanente, tarjeta del refugiado, tarjeta de autorización de empleo) Si esta es su primera vez aplicando, por favor traiga todos los documentos de inmigración con usted. Necesitaremos los números oficiales de ellos. ¡Una sonrisa grande! Cómo navegadores haremos nuestro mejor esfuerzo de facilitar este proceso. ;-) Si esta es su primera vez aplicando y tiene cualquier problema, le guiaremos a tomar los pasos necesarios para tratar de arreglarlo. ¡Nuestro trabajo es educar y ayudar a tomar el control de su salud! Si necesita cancelar, hacer otra cita o tiene preguntas, por favor llame al navegador con que están programados. Si no logra localizarlo, por favor llame 1-877-564-5031.

What To Bring To Your Navigator Appointment Marketplace Login and Password—this was a paper given to you by the navigator when you enrolled. If you have lost it please bring your email password (or have easy access to your email to reset the password) If this is your first time applying we will help create one for you. 2015 Tax Return and/or recent pay stubs (to help estimate 2016/2017 income) If this is your first time applying we will need income information for all members of the tax household (taxpayers and dependents) Social Security numbers of any new members of your household. If this is your first time applying we will need name, social security numbers and date of birth of everyone applying for insurance. Information about 2016/2017 employer insurance coverage offered to anyone in your household. Proof of legal status in the USA (i.e. green card, visas, work permits, etc.) for anyone applying for insurance in your household. Not applicable to US citizens. If this is your first time applying please bring all immigration documents with you. We will need the official numbers from them. A big smile ! As Navigators we will do our best to make this process as easy as possible. ;-) Our job is to educate and empower you to take control of your health and if there were any issues, we will walk you through the steps to try to get them fixed.If you need to cancel, reschedule or have questions please call the Navigator youare scheduled to meet. If you cannot reach them, please call 1-877-564-5031.

Post-Enrollment Materials