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Individual & Family Companion Guides

Individual & Family Companion Guides. May 16 , 2013 12:00-3:00 PM. Agenda. Carrier Testing. Paul – Carrier testing updates SFTP – Dropped updated 834 sample SFTP – Removed obsolete 834 samples SFTP – Dropped Readme.docx. Context. 820 Payment Advice Companion Guide.

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Individual & Family Companion Guides

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  1. Individual & Family Companion Guides May 16, 2013 12:00-3:00 PM

  2. Agenda

  3. Carrier Testing • Paul – Carrier testing updates • SFTP – Dropped updated 834 sample • SFTP – Removed obsolete 834 samples • SFTP – Dropped Readme.docx

  4. Context

  5. 820 Payment Advice Companion Guide • Walk thru outgoing 820 Companion Guide • Walk thru incoming 820 Companion Guide

  6. 999 Acknowledgement - Overview

  7. 999 Companion Guide • Walk thru 999 / TA1 Companion Guide

  8. 834 Follow up • Federal Payments • APTC – Advanced Payment of Tax Credits • The family eligibility for APTC is determined in the Exchange • The APTC amount elected by the family is captured in Healthplanfinder, displayed on applicant screens and sent to Carriers in the 834 in the 2700/2750 segment. • A copy of the 834 is sent to CMS so that they can pay Carriers the APTC amounts. • CSR Amount – Definition and how carriers are paid. • # enrolled in this particular plan variation • Paid by CMS per member per month * CMS factor • 834 – 2750 CSR Category is the plan variation

  9. 834 Follow up - Plans & Benefits Template

  10. 834 Follow up - Cost Share Variances

  11. 834 - Scenarios • 834 Enrollment, Cancel, Changes and Termination Scenarios • WAHBE_Enrollment_Scenarios_And_Cancellations_V4-3 • WAHBE_Enrollment_Scenarios_Change_V4-3 • WAHBE_Enrollment_Scenarios_Termination_V4-3

  12. Contact Information • Enrollment: Courtney Eiswald • Courtney.Eiswald@WAHBExchange.org • Testing: Paul Price • Paul.Price@WAHBExchange.org • Technical: Don Cotey • Don.Cotey@WAHBExchange.org • SFTP: Michelle Scott • Michelle.Scott@WAHBExchange.org

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