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GEAR Newsletter: March, 2016


OE3 debrief

Thank you to everyone who joined GHF, HHS, and Enroll America for the OE3 debrief! We appreciate everyone’s feedback on what went well, what can be improved upon in the future, and plans for OE4. We had great participation from all the partners in attendance and look forward to continuing to work with all of you. If you have any questions or comments about the debrief, please contact Whitney at 404-567-5016 x 5.


New SEP requirements – We want to hear from you!

CMS recently announced new requirements that require enrollees to provide proof for SEP enrollments. Failure to provide supporting documents may cause the Marketplace to deny an SEP. At GHF, we want to make sure that this new requirement is not putting up unnecessary barriers for consumers. If you are experiencing problems enrolling consumers during a special enrollment period due to the new requirements, we want to hear from you! Please use this SEP story collection form to let us know about any issues you may be experiencing. Once completed, please return the form to Pranay.

Say what??? Do you know how to allocate and reconcile premium tax credits for shared policies? 

Buckle up – we’re going to deep dive into a complex issue that has been popping up for enrollment assisters: shared policy allocation. What is that? Shared policy allocation is when consumers who receive tax credits as a household (i.e. a married couple or a family) need to split up their tax credits because they are now filing taxes separately. If allocation is not done properly, it may lead to tax filing complications and a delay in tax returns.

Here’s what you need to know: Allocations are reported on Part IV lines 30 – 33 of the form 8962. Allocation can be done in three different ways: (1) agreement based (2) non-agreement based and (3) 100% allocation. For more information please check our new resource.

We know this is tricky! If you have any questions or would like more information please contact Pranay at 404-567-5016 x 4.


As we all know, enrollment is a year round activity. However, once tax season is over you may have a bit more time on your hands. The months between open enrollments are a great time to do post enrollment education. Our GEAR resources provide a wide range of post-enrollment assistance materials for enrollment assisters.

Finding a Primary Care Provider

Health Insurance Complaints and Appeals

ACA and Taxes

If you have any questions regarding post-enrollment assistance and resources, let us know!


Guidelines on Overlapping Medicaid and Marketplace Enrollment

Have you dealt with consumers that have had overlapping Medicaid and Marketplace coverage? It can be tricky, but the IRS has finally released guidelines on how to handle these situations. Fortunately, our friends at the Georgetown University Center for Children and Families have written a blog post to help explain the IRS guidelines. This resource is also helpful for anyone working with a consumer that had a retroactive Medicaid eligibility determination.

Plain Language Working Group – In the Loop
Plain language materials can be very helpful while assisting consumers. A group of In the Loop enrollment assisters has come up with “plain language” explanations of health insurance terms and concepts to better help consumers understand complex health insurance terms. This resource from the plain language working group aims to increase consumers’ understanding and confidence as they make decisions about their health insurance.


Premium Tax Credits Tips and Tricks 
Health Reform: Beyond the Basics

Tax Filing Preparation: FAQs in the Navigator Resource Guide