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Broker Platform
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Training Topics
1. EDE Overview
2. Platform Overview
3. Broker Quoting
4. Broker Renewal
5. EDE Application
6. Post Enrollment Tools
7. Client Self Enrollment
8. Client Dashboard
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Enhanced Direct Enrollment
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What is Enhanced Direct Enrollment?
EDE is a new CMS technology. HealthSherpa was the first to implement EDE and is one of the only enrollment platforms that has this new technology.
Enhanced Direct Enrollment allows HealthSherpa to fully integrate with HealthCare.gov so you can do applications entirely on HealthSherpa without being redirected to HealthCare.gov.
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ACA Technology Comparison
Capability Double Redirect Enhanced Direct Enrollment (EDE)
Quoting
Plan Selection
Enrollment HC.GOV
Eligibility HC.GOV
Payment HC.GOV
Document Management HC.GOV
Effectuation Carrier
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Three Phases of EDE
All EDE implementations are not created equally:
Entities have the option to implement one of 3 phases of EDE in 2019 OEP:
% of Cases Covered
~60%
HH Circumstances Covered
Simple Cases only
PHASE I PHASE II PHASE III
% of Cases Covered
~95%
HH Circumstances Covered
Phase I + Students, Naturalized & Non US Citizens, Pregnant applicants, step children, grandchildren, foster care
% of Cases Covered
100%
HH Circumstances Covered
Phase I + Phase II + Rare tax circumstances: Not filing, married, but not filing jointly, child not on tax return, dependents over 25
Live Today 2020 OEP
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Additional Post Enrollment Functionality
New EDE Features:
● Make First Payment
● Upload Documents
● Prefilled renewals
● Report changes
● Search & Add Clients
More visibility with EDE Reporting:
● Get Binder Payment Status
● Get Document & Verification Status
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How to make a previous HealthSherpa application an EDE application:
Some applications may not have EDE functionality yet.
To enable EDE features, simply click on the client's name, and if EDE is not enabled, you will see an option to 'Enable EDE'.
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Platform Overview
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Get EDE Approved
Turn on EDE to:
● Complete applications on HealthSherpa directly
● Quickly effectuate plans with document upload / payment button
● View document and payment status without having to go to Healthcare.gov
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Help Center
Access the Agent Help Center from this button
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Help Center
● Getting Started Guide
● Helpful articles on FAQs
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Start Application
Start a renewal or a new application from this button
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Add Clients
Quickly add Marketplace clients to HealthSherpa
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Clients Tab
Displays all clients who have submitted applications
Additional features
● Quote● Renew● Filter ● Bulk email
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Clients Tab→ Client Details
Client details gives you the plan details and follow ups of each client
Additional features
● Effectuation to-do list● Quick action buttons ● Members on policy● Coverage details
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Clients Tab→ Client Details
Client details gives you the plan details and follow ups of each client
Additional features
● Client notes● Application history
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Leads Tab
Displays all leads that have begun quoting, shopping or applying, but have not yet submitted an application
Additional features
● Filters● Actions: Resume● Dynamic search
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Leads Tab→ Lead Details
Displays additional details relating to the lead
Additional features
● Resume● Eligibility● Contact information● Chosen plan● Notes
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Marketing Tab
Marketing tab contains a unique broker link to send to clients
Additional features
● Clients can self enroll● Filters into leads tab● Retains broker NPN
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Broker Quoting
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Broker Quoting
Quickly quote and search for plans
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Broker Quoting
Quickly quote and search for plans
Additional features
● Add dependents● Update income● Eligibility determination● Save lead
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Broker Quoting
Quickly quote and search for Marketplace plans or Stand-alone Dental Plans*
Additional features
Filters● Premium● Deductible● Prescription● Provider● Metal level● Network
* Stand-alone dental plans require that an applicant also have a Marketplace health plan
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Broker Quoting→ Compare plans
Compare plans side by side
Additional features
● Compare plans● Email to client
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Broker Quoting→ Compare plans
Compare plans side by side
Additional features
● Compare plans● Email to client
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Broker Quoting→ Send to client
Begin quote and email to client
Additional features
● Add custom message● Includes resume link
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Broker Quoting→ Add to Cart
Select the health plan your client would like to enroll in and click “Add to cart”
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Broker Quoting→ Add to Cart
From here you can jump into the health application by clicking “Start Application”
You can also help you client find a Stand-Alone Dental plan by clicking “Shop Dental”
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Broker Quoting→ Dental
You can also click over to the Dental tab from the Plan Results page, to see the plans available to your client
Additional Features
● Filter by monthly premium, network or company
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Broker Quoting→ Add to Cart
Once your client selects a dental plan, you can click “Add to cart” to view both the health and Stand-Alone Dental plan
Clicking “Start Application” drops you into the application process
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Broker Renewal
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Broker Renewal
Quickly quote and search applications on the Marketplace
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Broker Renewal
Quickly quote and search applications on the Marketplace
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Broker Renewal
Quickly quote and search applications on the Marketplace
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Application
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Marketplace Application
With Enhanced Direct Enrollment the application is completed on HealthSherpa
Additional Information● Renewals are prefilled
*Note: Application steps vary by household
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Post Enrollment Tools
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With HealthSherpa document
management, upload your client’s
documents and view statuses.
Document Upload and Status
● Identify required documents
● Upload documents
● Get the status
● Alerts and updates
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With HealthSherpa payment
integration, you can make your
client’s binder payment
Binder payment
● Make binder payment
● Get the status
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Change Plan, Report Life Changes
Easily update
applications
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1095-A forms & Eligibility Notices
Easily download client documents
● 1095-A Tax Form
● Eligibility Document
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Making a previous application an EDE application
Click “Enable EDE” on previous applications to have access to EDE features
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Client Self Enrollment
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Client Self Enrollment
Quote using zip code and email
Additional detail
Email is optional, when used, it creates a lead record on your agent dashboard
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Client Self Enrollment
Spouse & dependents
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Client Self Enrollment
Income
Additional detail
There is an income calculator tool available for self enrolling clients
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Client Self Enrollment
Income Calculator
Calculate income
● Annual● Monthly● Weekly● Per Project
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Client Self Enrollment
CSR
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Client Self Enrollment
SEP Verification (if applicable)
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Client Self Enrollment
Plan Selection
Additional filters
● Premiums● Deductibles● Providers● Prescription● Network types● Metal tiers
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Client Self Enrollment
Plan details page
Additional Information
A client can click into a specific plan to see additional information regarding the plan
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Client Self Enrollment
Save Progress
Additional Information
When a client saves progress, they can pick up where they left off later.
This also creates a lead in the broker dashboard
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Client Self Enrollment
Choose plan
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EDE Application experience is the same for brokers and consumers.
Note if client is self enrolling using your enrollment site, there is an ID proofing step
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Client Dashboard
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To-Do List
● Intuitive to-do list identifies
follow ups for your clients
● Clients can submit their own
documents and payments
directly from HealthSherpa
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Documents
● Identify documents needed
● Upload documents
● Get status / Approval
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Plan Details
● Current year’s plan
● History of Marketplace apps
● Coverage Details
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Payment
● Make Payments
● Get Payment Status
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HealthSherpa Broker Support
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HealthSherpa Broker Support
In the event of feature questions or technical issues, HealthSherpa’s broker support is available
PHONE
CHAT
(888) 684-1373
Chat from dashboard
Open 8am-4pm PST during SEP
& Extended hours during OEP and surrounding the deadline day
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Appendix
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Cases that will require a redirect to Healthcare.gov
● American Indian and Alaskan Natives● Applicants with no home address, living
separately or living at home address that is in a different state than where they are applying for coverage
● Applicants who are not planning to file a tax return or married applicants who are not filing a joint tax return
● Applicants responsible for a child 18 or younger who lives with them but is not included on tax return
Don't worry, we will identify these for you and redirect you to Healthcare.gov when necessary. Once you complete the application on Healthcare.gov, you will be redirected back to HealthSherpa to finalize the plan. These clients will appear in your Clients section of your dashboard.
● Applicants who are offered coverage through their job, someone else’s job, or COBRA
● Applicants with dependent children who are over 25 or who are married
● Applicants with dependent children living with a parent not on their tax return applying for coverage
● Applications where dependents that are applying are not being claimed on taxes.
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● CRM for your ACA clients● Easy Quoting● EDE- Enhanced Direct Enrollment● Complete applications on HealthSherpa ● Upload required documents● Make binder payments● Print 1095A forms● Prefilled renewal● Search and Add Clients● Client Dashboard
Benefits