GEAR

UPDATES AND CHANGES IN THE MARKETPLACE

Assister Help Resource Center (AHRC) Closed for the Season

The AHRC, a platform provided to enrollment assisters for post-enrollment assistance, is closed for the season as of April 15, 2016. We will let you know when it opens back up.

SEP for Consumers Moving out of the Coverage Gap 

Under CMS eligibility rules that began in April 2015, consumers moving out of the coverage gap because of income changes have 60 days from the date of income change to apply for coverage. This SEP is only available via phone request and cannot be done online. Enrollment assisters may need to take the consumer’s SEP application to the Marketplace supervisors if the first line of Marketplace representatives seem to be unfamiliar with this type of request.

Tax Filing and Reconciliation: Helping Consumers with IRS Letter 12C

Wait! Tax related work isn’t over yet. Tax filing period may be over but consumers may still need follow-up assistance. Enrollment assisters have been reporting that some consumers have received 0012C or 12C Information Request letters from the IRS after filing their 2015 taxes. We want to make sure you understand how to explain these letters to consumers and what to do about them. The IRS sends a 12C Information Request letter to those people that received an Advanced Premium Tax Credit (APTC), but did not include Form 8962 (Premium Tax Credit) with their 2015 taxes. Without Form 8962, the APTC cannot be reconciled. If consumers do not complete Form 8962 as part of their 2015 taxes, they will lose their APTC and cost-sharing reductions for the 2016 calendar year.

RESOURCE HIGHLIGHT

New Retiree Coverage 

Do you assist new retirees? This flowchart developed by In-the-Loop helps simplify the health insurance choices for new retirees who are not yet eligible for Medicare.

NEW MARKETPLACE RESOURCES

Assister Guide to the Immigration Section of the Online Marketplace Application 
CMS

Lessons Learned from the Third Open Enrollment Period 
Families USA