Articles

Marketplace Enrollment Walkthrough: HealthCare.gov – October 2016


>>Female Speaker: Today
we’re going to walk through the updated enrollment
experience for consumers that is coming with the 2017
open enrollment period. So getting started, there is
a to-do list for consumers that we have done lots
of consumer testing to kind of figure out
what makes the most sense for consumers to help set the
stage for the enrollment part of the process. So this is a family of
three scenario that’s already gone through their
application and viewed their eligibility results
and already seen the amount of tax credits that
they have available. This family will actually be
eligible for Cost-Sharing Reductions on Silver
Plans, as well. And we’re going to walk
through the updated enrollment experience so
that you can see how some of the screens might have
changed if you’ve been around in past years, and
also what the consumer experience will be as
they’re choosing a plan. And, again, this is after
they have submitted their application, have viewed
their eligibility results, and they’re ready
to select a plan. So this first step of
just deciding how much to lower your premium tax
credit; this is going to be our starting step. So as the consumers navigate
through the to-do list and the different steps to
actually get to the last one, “confirm and enroll,”
we have a tracking bar up at the top for the steps
and where they are. We won’t actually hop
through each one of these, in terms of coming back here
and having to click a button to start it; this will be
a continuous progression, which is an updated flow
that’s coming in 2017 for open enrollment. So we’ve actually
streamlined this a little bit for consumers so that
it feels a little bit more intuitive, but they still
have context of where they are in the process. And at any point in
time they can go back. So I’m going to go
ahead and get started. And you may see some
different information here for different
consumer scenarios. This is a new consumer
that’s enrolling through a special
enrollment period. Sometimes you may see other
dynamic content above this list based on whether
they’re a re-enrolling consumer and it’s open
enrollment, based on whether the consumer just
reported a life change and they’re simply updating
enrollment information, and you may see different
information if they have an SEP, but this is kind of
the core part of the page. And then sometimes they’ll
be more tailored content above here for you. Next step we’ve streamlined
how advanced premium tax credit and choosing how much
of that maximum APTC to use and the choice information. In prior years, this
information was spread across a couple of different
screens; roughly four. It was lengthy. A lot of the information
was repetitive and hard for consumers
to understand. So we’ve simplified
this down into one set of choosing the amount
of APTC to use. And in here, when we have
terms that consumers may not be familiar with or may need
more information on for what we’re asking, there are
underlines underneath words that then pop up with a
hover that include more information defining them,
or more information about what we’re asking to
help give the consumer additional help. There’s also a new help
drawer down at the bottom. So for each step through
the enrollment experience, there’s a “quick tips”
section that provides additional help information. So if we click on “see
tips,” this expands up as a help drawer with
additional information on a lot of different
things on the page. So as consumers need more
help, they can actually just pull this up
and read through it. They don’t have to open up
a new browser tab or a new window and toggle back and
forth; they can simply click through the
different pieces of help and then close the drawer
when they’re done. And, again, they can pull
that up again if they need to — if they need to
reference something else — or when we get to the
next section you’ll see this actually changes
and the help content down at the bottom is
specific to that next step. So choosing the amount
of tax credits, we’ve got three
choices for consumers. Most consumers generally
will end up probably using the maximum, but we want to
make sure for consumers that if they’re not sure about
how solid they’re income estimate is for this year
based on the application information they just
put in, they may want to not take the maximum. They may want to give
themselves a little bit of a buffer between that,
in case there’s some income adjustments between
their estimate on their application, and what
their real, final income would be when they go to
file their tax return for the future year. When they actually file
their tax return, they will get a calculation for their
actual premium tax credit based on their final
income for the year. So that can be different
than, obviously, the income estimate they made on the
application and the advanced premium tax credit that we
calculated based on that estimate of their income. So they’ll actually go
through that reconciliation process when they file their
taxes after the year has closed and they have final
income for the year. And then there’s a third
option for consumers that may want to not use
any of it upfront. This tends to be a good
action particularly for consumers that may
be closer to that 400 percent of the
federal poverty level, they may not have a lot
of tax credits to apply. And they may say,
“You know what? I’m actually okay
not using this now.” They’ll be able to claim
an appropriate amount of premium tax credit when
they file their tax return and get that back on their
income taxes based on their final income for the year. So if a consumer wants to
use all, they can simply click the button to
use all, each month. Or if they want to choose a
different amount when they say, “Enter an amount,” the
box will pop up and let’s say this family wanted
to use $600 a month. If they do that, then it
will change this middle option to say, “You have
chosen to use $600 a month.” And they can change it
again if they want to or they can go back and
pick a different option to use “none.” Or, for this scenario,
I’m going to go back and use “all” for
each month; all $625. When I continue to the next
step, if you’re following along, we’ve got our
progress tracking bar, just moving across. Again, this is
actually navigational. So if the consumer wants
to use this to go back to step two, they can. They can’t skip forward in
the summary for where they are in the steps to getting
enrolled; they would have to click the green “continue”
buttons at the end of each section, but, again, it’s
an easy way to go back. The other thing is, if
they want to change other information. So if we get through the
tobacco use questions for our consumers here, and then
they realize, “Oh, maybe I want to change the amount
of tax credits I chose.” They can also click
this to-do list, “change my information,” the
upper right hand corner, that stays there. And this takes them back
to something that looks familiar that was on that
first screen that actually shows what steps they’ve
completed so far and what step they’re on next. So if they want to go back
and change that information, they can hit “change”
and it’ll take them back to that step, or they can
just go ahead and start the next step. So this year we’ve
integrated the search for doctors, drugs, and
facilities before consumers see plans so that if they
search for any doctors or add specific
drugs that they want to check for plans with,
they’ll actually be displayed in the results
for their plan list. So I’m going to pick a
couple of providers just to help demonstrate
how this works. One thing to note is that we
show about five per doctor per facility section and
per prescription drug. So since I entered
“Smith” it actually comes back with potential
options for all three. If the doctor that they’re
looking for, for example, isn’t in the first five,
there is more here. So if you click “more”
it will just scroll the doctor’s list to
the next five. So if you’re looking for a
particular one and you don’t see it in the first five,
you can keep scrolling through more until you
find another doctor that you were looking for. And that’s true for both
medical facilities and prescription drugs. I’m also going to add
a prescription drug. So this is a quick search
that they can enter in any one piece of information at
a time, and then just erase it and enter in another one. So if I wanted to add
Lipitor, I can add Lipitor. If then, I wanted to search
for another doctor, let’s say I have Dr. Green that I
also wanted to add, then you can just erase Lipitor,
enter in Green and hit “search” or press “enter,”
and it will come up with a new search list. Once I have all of the
doctors, facilities, and drugs that I want to see if
plans cover and which plans cover them, you can scroll
down to the end, and there’ll be a green
“continue” button. And just wanted to
point out again, we have “quick tips”
for each step. So in this one, this is a
separate set of information about doctors and drugs
that’s helpful just for this particular page. Next step is for consumers
that may know that they have certain health
coverage needs next year. Can use what we’re you
call kind of a total yearly cost estimate. And we’re laying out for
consumers, this is helpful just from a perspective
of comparing how much in relative one plan may
cost you per year versus another plan. And this is simply an
estimate for helping to choose a plan and understand
the costs better. It has absolutely nothing
to do with real healthcare utilization; it doesn’t
have anything to do with the cost the consumer would
pay for the premiums. So for consumers that know
they have a certain number of drugs, they have maybe
surgery coming up this year, and they want to kind of
understand how much might I pay based on how much I
expect to use next year, they can use this and select
a level per person of low, medium, or high. And we’ll ask this for each
person in the household that is eligible to enroll
in a Marketplace plan. If consumers aren’t sure or
don’t want to use this step, that is totally fine. They can actually skip
it and it will skip it for each person. So for our household I’m
going to select a couple of different coverage levels,
but you’ll also notice this is slightly different for
each person based on who they are in the household. And finally, John
Carson, I’m just going to say is a medium
level to move on. Our last step before
consumer’s see their health plans is
“health plan groups.” By default, most consumers
that have more than one person in the household
will be grouped together. If consumers want to change
the default group, they can. This might be in the case if
you have two parents that want to put themselves on
one plan, but they want to get a different
plan for their child. They can move them to a
different group, and just by selecting “move to a
different group,” and then it puts Anna Carson
in a different group. For our walk through,
I’m going to keep them all in the same
group just for ease. If you have consumers that
have multiple enrollment groups, they go through this
“selecting a health plan” step twice and select a plan
for each group before they move on to the end of their
enrollment confirmation. So next I’m going to hit
“view plans,” and before we see plan results, we have
a couple of quick tips and features that we
call out for consumers. We’ve found through
consumer testing that it’s helpful to point these
things out to consumers, because it makes them easier
to find as they’re walking through the results. So the first step is to
point out that we have a hover over “tool tip”
that is an I in a circle. Whenever you see that, you
can mouse over it for a definition or additional
information on what it is. And I’ll show you one
of those in a minute. Also, we have all of the
filters available under “filter drawer,” which
is a green filter button. So instead of having all of
the filter options listed on the page, we’ve actually
condensed that into a filter area so you can pull it
down, change filters, and then see what filters
are applied at any point in time. And then lastly, the other
important thing to point out is the “compare
and save” check box. So this actually functions
for two different things, consumers can check this
box and select up to three plans that they can
compare side-by-side. We’ll also save the plans
that are checked over time. So if a consumer picks a
couple of plans they’re comparing them up, but
they’re not quite sure they want to enroll yet. Maybe they want to call
their doctor’s offices and just double check that
they’re covered in the plan, which is always a good idea. If they leave this checked
for any of the plans and return later,
they’ll still be saved as plans that they
had checked to save. So when I go to next,
we have a summary of some of the medal
levels available. This will actually
be dynamic based on the plans
in the area. In this example, we have
Bronze, Silver, and Gold Plans; they’re don’t happen
to be any Platinum Plans available in this area for
the consumer, but in an area where there are, there
would be a fourth section for Platinum Plans. For consumers that have
Cost-Sharing Reductions on Silver Plans, this looks
a little bit different, because we want to make
sure consumers understand that those extra savings —
which are specific to them, it’s not something that
everybody gets — are only available if they actually
select a Silver Plan. So, in those cases, we
actually highlight silver separately on the left. And we include a yellow
“extra savings” tag. So you’ll see this on any
plan for consumers that have Cost-Sharing Reduction
eligibility in Silver Plans, or for consumers that other
types of Cost-Sharing Reductions, you’ll see this
yellow, “extra savings” tag on any of the plans
that would actually give them that benefit. And this just provides a
quick, high-level overview of the number of plans
available per health plan category or metal level
and roughly kind of how the premiums compare across
the metal levels and average yearly costs if the consumer
entered this information. We also give the consumer
an option if they have Cost-Sharing Reductions for
Silver Plans to pre-filter their results list to only
see Silver Plans or they can see all plans to start. Consumers, this tends to
just be a preference; we find that some consumers
want to see everything first and narrow
information down later. And we have other
consumers that are like, “Great, if I should be
looking at Silver Plans because I can get extra
savings there, then let’s just start with that list.” These options can be changed
in the “filter plans” button at any point
in time, and we find it’s just up to
consumer preference. For our scenario,
I’m going to go ahead and say,
“See all plans.” “See all Silver
Plans,” sorry. And you’ll see up at the top
right here, this is where we put all of the filters
that are currently applied. So we’ve got silver applied,
and we also have a button to clear filters. So at any point in time,
consumers could X out of a particular filter
or clear them all. So you’ll see as a summary,
we’ve got 10 health plans available for Susanne,
Anna, and John, with an estimated effective date
of 11/1/2016, excuse me. You’ll also see here this
yellow “extra savings” tag that I pointed out on the
prior screen across the couple of plans since I have
them filtered to silver. So as we’re looking
through our plan results, we have our monthly
premiums, our deductible, our out-of-pocket maximum,
family total, sometimes you’ll see additional
information on here for certain plans, as well. Our co-payments and
co-insurance — if consumers decided to get an estimate
for total yearly costs, you’ll see that in this box. These “change” buttons here
will actually take you back into that step if
you want to edit any of the information. And then, also, the
providers, if they’re covered, there’s a quick
kind of battery bar that tells you whether how
many of the ones that you entered are here. In order to see which ones
are specifically covered, consumers can click on this
“quick view” button, and it pulls up a little bit of
expanded information for consumers, but without going
into a full page of all of the details. So it gives them a quick
idea for some of the additional cost
information without having to navigate to the “full
plan details” page. And, again here, you’ll see
with providers, which ones are actually covered and
if they’re in network, and which locations they
are covered in network. And, again, if the
consumers need to go back and change any of their
doctors or drugs, they can do that here. Also, as we pointed out,
the “tool tip” eyes include the hovers
for definitions for what information — what
these boxes really mean. So consumers that aren’t
sure what a deductible covers, you can mouse
over the “I” as a tool tip to get some
information on that. I’m going to close out
of the “quick view” and scroll through our
lists a little bit. I’m going to pick a couple
of plans to compare side-by-side in our list. And you’ll see as I clicked
on them; so if I unclick and I click again — as soon
as we started adding them, there was this new box up at
the top that says “compare and save,” and we’ve got
three plans selected. If we only had two plans,
it adjusts dynamically based on what the
consumer has selected. So if I go in and say,
“Compare and save plans,” consumers will see a
side-by-side comparison of summary level
information and costs for each of the plans. So they can compare
across the premiums, the deductibles, the
out-of-pockets, co-payments, co-insurance, how some of
the estimated total yearly costs could change if they
interacted with that, and whether dental coverage is
included, depending on the plan, whether child or
adult dental is covered. And if consumers want more
details on a particular plan, they can go
into more details. This will give them the
full page view of all of the benefit and
coverage information for a particular plan. So that includes everything
from costs for medical care, prescription drug coverage,
access to doctors and hospitals, hospital
services, etcetera. So you’ll see a magnifying
glass icon on things like “limits and exclusions,”
which will give you additional details about
benefits and what might be covered under a
particular area. So you can always
click on that to view additional details. So all the way, I’ll just
scroll the bottom real quick; you can see there’s
a lot of information here for anybody. And at the bottom there
is an “enroll” button. If the consumer is
solid and they think this is their plan,
that’s great. They can go ahead and click
that “enroll” button. If they want to go back and
pick a different plan or go back to their side-by-side,
they can just click this “back” button and get
back to their main list. So, also, we have the
ability for consumers to sort their plans. Plans are default sorted by
premium initially when they first land, they can change
to sort by deductible, or they can sort by their
total cost estimate if they provided some of that to
help get a better idea of what, roughly across
the year, different out-of-pocket costs
could add up to for different plans. The other thing to
highlight here is our filter capabilities. So if I click on “filter
plans” we’ll see that I already have silver
selected, and consumers can actually change — these are
sliders — for the premium amounts for the estimated
yearly costs, and the max yearly deductibles. So they can drag these
sliders if they want to filter their results
down to a dollar amount. So if this consumer only
wanted to see plans that were $700 dollars or less
per month, we can adjust that premium slider. And if they wanted to filter
on a particular plan type or — we also have the ability
now for consumers to filter on specific doctors or
drugs that they provided. So if they want to just see
the plans that cover one of their doctors, they can
check one of these boxes, or two of these boxes. Same thing if they
have multiple drugs. They can check those
and see which plans are currently covered. There’s also a
“search by plan” box. This is more for consumers
that might have gone through and previewed plans before
open enrollment and had a particular plan they
wanted to look up. I wouldn’t expect most
consumers would be using this, but it is available
just in case you have something that you wanted
to pull up that maybe you previewed through our
“see plans” tool before open enrollment or at
another point in time during the year. So if I go ahead and apply
the new filters that I added which was a premium,
I unchecked “silver” but then changed it
to “premium” so that I could see a different
list of plans. You’ll see now, I
have “monthly premium of less that $700.” I can actually go in and
add “silver” again so that we can see a
different set of plans. So you’ll actually now see
that the different health plan categories are
available to apply as filters. So now I have a couple
of filters applied. I’ve got “monthly
premium less that $700,” I have “silver.” I can click on any one
of these to close out the filter, or I
can do that in the filtered part [phonetic sp]. So let’s say I unclick
“silver,” silver filter goes away, and now the only
filter that’s currently applied is “monthly
premium less than $700.” One of the other things
that we make sure we do for consumers that have
Cost-Sharing Reductions in Silver Plans, is if
they enroll in a plan that doesn’t provide that —
doesn’t provide that benefit, we’ll flag
it for them when they go to enroll. So for demonstration
purposes I’m just going to choose a Bronze Plan to
enroll in so that you can see the language and
information we include. So there’s a confirmation
before the consumer gets to the very end. So this is the current
plan that they selected, it highlights whether any
dental benefits might be included for
adult or children. And then we actually ask
and confirm if they want to enroll in this plan. And this highlight box
here calls out that they qualify for extra
Cost-Sharing Reductions, but they have to enroll in
a Silver Plan. And then the
consumers can decide, “Yes, I actually want to
enroll in this plan without the extra savings,” or,
“No, show me Silver Plans, I’ll go back and make
a different selection. So when I click that button
and come back, I actually now have the “silver”
option filter applied. So if I pick a Silver Plan
to enroll, then again, we’ve got the summary of dental
included or not included in this plan. And then, a confirmation
of whether this is the one they’d like to select. If you have consumers that
have more than one health plan group, after saying
“yes” to this and “continue,” you would head
back into the plan selection for a health plan for the
next enrollment group. And then on our confirmation
for plan choices, you’ll see a summary. This will include all the
different plans that the consumers may have selected
that are health plans. So, again, if you have
multiple enrollment groups, we’ll see this screen
with more than one set of plan information. We have a summary,
again, by person about whether they would
have dental coverage in the plan selected. And then we ask the
consumers if they’re interested in separate
dental coverage. If they say, “Yes,” they
go through a very similar process to select a dental
plan that we just walked through for health plans. For — walking through for
the dental purposes — I’m going to
skip the dental. It works and functions
just like a health plan. So any consumers that are
interested in separate dental coverage can
go through that. If they’re not, they
can just say, “No.” The other thing to make sure
that you do as an assistor or a navigator, or an agent
and broker, is there’s another link here that
says, “Did someone help you select to plan and enroll?” This is actually where
you would enter in your information to make sure
it actually gets attached with the enrollment. So enter in your
organization name, your first name, and you I.D.
numbers as appropriate. Before the consumer
continues, we have a “agree and confirm” statement
that’s been here for a little bit that’s just about
Medicaid or CHIP coverage, and the fact that you can’t
have Medicaid and CHIP and premium tax credits at
the same time so they would need to report a change
if they became eligible for those programs at a
future point in time. As we get towards the
very end, we have our attestations for
advanced payments of the premium tax credit. This is just making
sure that the consumer acknowledges and understands
that the premium tax credit is paid in advance on their
behalf directly to the insurance company and they
have to file a federal income tax return for the
tax year where they’re receiving the tax credits. If they’re married, they
have to file a joint return with their spouse, and
we also have additional statements that you should
read through with consumers as we go through. At the very bottom is
our “agree and confirm” statement for tax credits
which is for the tax filer. And then we have our
“finish plan” selection. So as we get to the very
end, we’ll have our final “you’re almost done” screen. So for consumers, this is
the last step with us with the Marketplace for
enrollment, but they’re not actually done. They have to pay their
premium in order for coverage to start. So we want to make sure
consumers understand that while they’re done selecting
a plan, and they’re good to go from a Marketplace or a
healthcare.gov perspective, they still have to make that
first premium payment to their plan in order for
coverage to actually start. And if you had consumers
that had selected more than one health plan or had
dental coverage, you’ll see each plan summarized here
along with the estimated effective date and if
they have other customer service information
available for the plan. If they have a plan that
offers online payment, then there will be a green “pay
for health plan” button that they can click and
go over to that plan. And if not, the plans
customer service phone number information would be
available for the consumer to write down and save for
later or they can always access this by logging
in and selecting their appropriate year application
and then navigating over to the “my plans” in
programs part of our website to see a summary of their
enrollment information. And that concludes
our walkthrough of our enrollment
experience.

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