HIX/Tier-1 Worker Portal: Application Differences and Screenshots

1. HIX/Tier-1 Taking an Application Using the HIX/Tier-1 Worker Portal to take an application Module 116 Appendix L –HIX/Tier-1 Worker Portal Screenshots

2. Comparison Between Consumer and Worker Portal Applications. • A Screen Walk-though and Key “Gotchas”. • How to Take a Telephonic Signature. • How to Explain the Results. • Responding to detailed questions • Triggered Notices.

3. Application Differences between the Consumer and Worker Portals • Ultimately the consumer portal and worker portal gathers the same application data. The intake and change reporting processes are very similar, but there are some subtle differences. • The user interface looks a little different. • The consumer portal has more popup and float-over help. • The worker portal has more ability to “click around” as opposed to being totally guided navigation. In the consumer portal the navigation is more constrained. Appendix L –HIX/Tier-1 Worker Portal Screenshots

4. Application Differences between the Consumer and Worker Portals • The calls to the federal data services hub are in different places. • The consumer portal calls the individual services after it has been to certain screens, i.e., checks income after the income screens. • The worker portal calls the services (mostly) when the Submit button is clicked. • The consumer portal is arguably the better way as it prevents triggering unnecessary verification checks when doing change reports. Appendix L –HIX/Tier-1 Worker Portal Screenshots

5. Taking a new application follows this call flow NOTES In this module we will focus on the practical aspects of these steps. Later modules look address enrollment, etc.

6. Worker Portal screen sections and individual screens Flow top down through the sections, and left to right through the screens. Screens can be optional based on the answers to questions.

7. Worker Portal screen sections and individual screens The rest of this module is organized section-by-section and screen-by-screen. Flow top down through the sections, and left to right through the screens. Screens can be optional based on the answers to questions.

8. Applicant and Family Appendix L –HIX/Tier-1 Worker Portal Screenshots

9. Applicant and Family – Application Information • This is the starting point for a new application. • Set the filing date to the current date. • Set the channel to Telephone. • Set “Apply for Subsidy” to Yes. • The Document ID is not needed. That is for paper applications. Appendix L –HIX/Tier-1 Worker Portal Screenshots

10. Applicant and Family – Household Members Once you start the application, you need to add in the household members. Even if they do not need coverage, you need to add the people that are in the household or on the tax filing. Click “Add/Edit” to add the people. Appendix L –HIX/Tier-1 Worker Portal Screenshots

11. Look for the household members in the system • The “Add/Edit” pops up this search screen to try to find the people in the master person database. • Even if they are not in the HIX/Tier-1 system they may be known to other systems. • Enter all the information and look at the results. If there is a GOOD fit (e.g., same SSN) then select the person using “Assign Applicant”. • If nobody is found then click “Create New Record”. Appendix L –HIX/Tier-1 Worker Portal Screenshots

12. Create a new person record Complete the fields and click “Add” to add the record. This record will now appear in the search results and you can select it. Appendix L –HIX/Tier-1 Worker Portal Screenshots

13. Applicant and Family – Household Members After adding the household members this screen will be populated with those individuals. Appendix L –HIX/Tier-1 Worker Portal Screenshots

14. Household Relationships Appendix L –HIX/Tier-1 Worker Portal Screenshots

15. Household Relationships • Once you complete the Applicant and Family, you will need to assign the relationships between the applicants, whether they are apply for coverage or not. • Notice the progress menu on the left hand side of the screen. • You can use that to navigate directly to different sections in the application. Appendix L –HIX/Tier-1 Worker Portal Screenshots

16. Application and Family – Relationships To add the relationship, click on the Add/Edit, and choose the relationship which best describes the members of the household. Appendix L –HIX/Tier-1 Worker Portal Screenshots

17. Application and Family – Relationships To add the relationship, click on the Add/Edit, and choose the relationship which best describes the members of the household. Domestic Partner is typically misunderstood and should not be used. It was used as an alternative prior to the recognition of same-sex marriages. It is not a “common law” relationship. Appendix L –HIX/Tier-1 Worker Portal Screenshots

18. Application and Family – Marital Status • On the same screen, you will need to provide the marital status of each person, and their associated details. Appendix L –HIX/Tier-1 Worker Portal Screenshots

19. Application and Family – Caretaker Relatives • You can assign someone as a Caretaker Relative for the children in the home who are under 19yo. • A caretaker relative is a blood relative (uncle/aunt, grandparent, etc.) living in the same home with a child under 19 whose parents are not present in the home. • They must be related to the child by: • Blood • Adoption • Marriage (or is the spouse or former spouse of those relatives) Appendix L –HIX/Tier-1 Worker Portal Screenshots

20. Application and Family – Foster Care Information You capture any former Foster Care details. This is used to establish eligibility for the HUSKY former foster care program. This covers children who aged out of foster care at 18yo in Connecticut. Appendix L –HIX/Tier-1 Worker Portal Screenshots

21. Contact Information Appendix L –HIX/Tier-1 Worker Portal Screenshots

22. Contact Information – Primary Applicant Home Address Once the members of the Household are identified, then it is time to collect the home address, mailing and phone number of the household. It is also possible to label someone as “No Home Address”, i.e., homeless. A mailing address is needed in this circumstance. Appendix L –HIX/Tier-1 Worker Portal Screenshots

23. Contact Information – Residency If there were multiple household members you could record alternate addresses. Appendix L –HIX/Tier-1 Worker Portal Screenshots

24. Contact Information – Living Arrangement We need to establish explicitly the living arrangements of the household members. Usually this will be “At Home” but there can be some exceptions for individuals who have been institutionalized. Appendix L –HIX/Tier-1 Worker Portal Screenshots

25. Person Information Appendix L –HIX/Tier-1 Worker Portal Screenshots

26. Person Information – Tax Status After defining the household as a whole, the application moves into capturing the individual details of each person. It starts with the tax status. After defining how they file their taxes, or if they are dependents, you need to add the yearly income for each person, by clicking on “Add Yearly Income.” Appendix L –HIX/Tier-1 Worker Portal Screenshots

27. Person Information – Tax Status – Yearly Income This is an estimate of how much gross income this person will report on their tax forms. Specifically it is the modified adjusted gross income (MAGI). MAGI is the total of a household's adjusted gross income (AGI) plus any tax-exempt interest income they may have (these are the amounts on lines 37 and 8b of IRS from 1040) Appendix L –HIX/Tier-1 Worker Portal Screenshots

28. MAGI Income • Someone’s gross income may be the same as their AGI which may be the same as their MAGI. • The Adjusted Gross Income is shown on someone’s tax forms. If you subtract applicable deductions from the total income, you are left with your adjusted gross income on line 37 of the Form 1040. • The 1040 form lists the exact deductions you can take, including tuition and fees, educator expenses, moving expenses, alimony, student loan interest, and deductions for IRA contributions • The Modified Adjusted Gross Income is usually very similar to the adjusted gross income, with a few items added back in. It does not have its own line on Form 1040. • You can compute it by eliminating deductions for IRA contributions, student loan interest, tuition and fees, and any exclusions for foreign earned income or housing Appendix L –HIX/Tier-1 Worker Portal Screenshots

29. MAGI Income • The MAGI income is used to calculate advanced premium tax credits (APTCs) if someone doesn’t qualify for HUSKY. • If someone underestimates or overestimates their MAGI income, they will need to reconcile their APTCs with the IRS at tax filing time. Appendix L –HIX/Tier-1 Worker Portal Screenshots

30. Person Information - Pregnancy • This screen is only shown when there are women in the household. • We capture if anyone in the household is pregnant and the details. • This can seem too personal to some and not a standard health insurance question. • Or to some, it may seem like we are trying to screen them out in some way. • But the reverse is true. The information is used in the determination of HUSKY coverage and they are more likely to be covered if they are pregnant. Appendix L –HIX/Tier-1 Worker Portal Screenshots

31. Person Information – Disability Status • If any members of the household has a Physical Disability or Mental Health Condition, this is where it is indicated. • This is used to: • Screen for other types of HUSKY coverage. • Allow children to continue on their parent’s insurance past age 26 Appendix L –HIX/Tier-1 Worker Portal Screenshots

32. Person Information – Citizenship and Immigration Status Citizenship and lawful Immigration status is a key eligibility component. Appendix L –HIX/Tier-1 Worker Portal Screenshots

33. Person Information – Ethnicity and Race Ethnicity and race are optional and are only used for federal reporting. If the client wishes to provide their race, this is where it is captured. It is not required. Appendix L –HIX/Tier-1 Worker Portal Screenshots

34. Income Information Appendix L –HIX/Tier-1 Worker Portal Screenshots

35. Income Information – Current Income and Deduction(s) We now start to collect their current income. The previous annual income is used to calculate APTCs. Current monthly income is used to determine HUSKY eligibility. If additional income is needed (such as the client works multiple jobs or has different employers in the year), press the Add Income button to add additional information. Appendix L –HIX/Tier-1 Worker Portal Screenshots

36. Income Information – Previous Months Income and Deduction This question should be asked of the caller differently. “If you have some unpaid medical bills from the past 3 months, we could look to see if you would qualify for HUSKY in those months. The bills would only be paid if the provider was a HUSKY Health provider. Is this something you would like to do?” Appendix L –HIX/Tier-1 Worker Portal Screenshots

37. Detailed Person Information Appendix L –HIX/Tier-1 Worker Portal Screenshots

38. Detailed Person Information – Tribal Status If the client is part of a tribe, this is where it is indicted. Tribal membership can reduce out-of-pocket expenses for some health plans. Appendix L –HIX/Tier-1 Worker Portal Screenshots

39. Detailed Person Information - Impairments If the client has any Impairments, such as Behavioral, Hearing or Speech, it is indicated here. Appendix L –HIX/Tier-1 Worker Portal Screenshots

40. Detailed Person Information If the client requires any accommodations, it is indicated here. Accommodations can be made to help those who need extra assistance. This information is not used in the determination of health coverage. Appendix L –HIX/Tier-1 Worker Portal Screenshots

41. Detailed Person Information If the client is a veterans of the Armed Forces, it would be indicated here. Appendix L –HIX/Tier-1 Worker Portal Screenshots

42. Family Health Coverage Appendix L –HIX/Tier-1 Worker Portal Screenshots

43. Family Health Coverage – Health Insurance It is important to know if any member of the household is going to be receiving any type of health coverage, even if it is not from the client’s employer. Alternative health coverage can affect APTC calculations and HUSKY B eligibility. Appendix L –HIX/Tier-1 Worker Portal Screenshots

44. Family Health Coverage – Health Coverage from Another Employer If a member of the household is offered health coverage from a job, more information is needed about that employer. Appendix L –HIX/Tier-1 Worker Portal Screenshots

45. Family Health Coverage – Currently Enrolled in Health Coverage If a member of the household is already receiving health insurance, the information related to the insurance is required. Appendix L –HIX/Tier-1 Worker Portal Screenshots

46. Special Enrollment Appendix L –HIX/Tier-1 Worker Portal Screenshots

47. Special Enrollment Questions Most QHP enrollment occurs during the short (~6 week) Open Enrollment period. To qualify for QHP health coverage during Special Enrollment (i.e., NOT Open Enrollment), the consumer must prove a qualifying life event has occurred. These questions try to establish whether there are any qualifying life events. Appendix L –HIX/Tier-1 Worker Portal Screenshots

48. Special Enrollment Questions There are more SE questions. FYI: If the system makes someone ineligible for HUSKY, then it knows they have lost coverage and so qualify for a special enrollment period. Appendix L –HIX/Tier-1 Worker Portal Screenshots

49. Confirm Application Appendix L –HIX/Tier-1 Worker Portal Screenshots

50. Confirm Application – Yearly Renewal Confirmation Once the application is ready to confirm, the client would need to give permission to access tax return at renewal time. You should explain that this can allows us to renew them next year without them having to contact us. Recommend 5 years, but it is their choice. Appendix L –HIX/Tier-1 Worker Portal Screenshots