Jan
14
NY State of Health Application Instructional Video


Woman: IN OUR DEMO TODAY, WE WILL BE GOING THROUGH AN APPLICATION FOR A FAMILY — A SINGLE MOM, JOSEPHINE, AND HER SON, MARVIN. BOTH OF THEM ARE LOOKING TO PAY FOR HEALTHCARE COVERAGE. AT THIS POINT IN OUR SCENARIO, JOSEPHINE HAS CREATED AN ACCOUNT AND HAS BEEN IDENTITY-PROOFED. AND ACCOUNT HOLDERS ARE IDENTITY-PROOFED SO THAT THE MARKETPLACE CAN PROTECT A CONSUMER’S PERSONAL INFORMATION AND PRIVACY. ON THIS FIRST PAGE OF THE APPLICATION, WE ENTER IN BASIC INFORMATION ABOUT THE FAMILY. WE ASK CONSUMERS TO INCLUDE THEMSELVES, THEIR SPOUSE, ANY CHILDREN THEY ARE TAKING CARE OF, AND ANYONE THEY WILL INCLUDE ON THEIR FEDERAL TAX RETURN. JOSEPHINE’S INFORMATION WAS PRE-POPULATED FROM THE ACCOUNT-CREATION PROCESS. SHE ENTERS IN INFORMATION ABOUT MARVIN. WHEN FILLING OUT THE APPLICATION, IT’S IMPORTANT TO CLICK ON THE BLUE BOX AT THE TOP OF THE SCREEN IF YOU WANT THE MARKETPLACE TO SEE IF YOU QUALIFY FOR FEDERAL FINANCIAL ASSISTANCE. ON THE FIRST SET OF SCREENS, WE ASK FOR DEMOGRAPHIC INFORMATION ABOUT EACH PERSON ON THE APPLICATION. THIS INFORMATION WILL HELP THE MARKETPLACE DECIDE WHAT PROGRAMS YOU QUALIFY FOR. WE ASK ABOUT MARITAL STATUS TO SHOW YOU THE RIGHT PLANS THAT YOU QUALIFY FOR. JOSEPHINE’S DATE OF BIRTH AND SOCIAL SECURITY NUMBER ARE PRE-POPULATED FROM THE ACCOUNT-CREATION SCREEN. WE THEN ASK ABOUT HER CITIZENSHIP OR IMMIGRATION STATUS. THE MARKETPLACE NEEDS TO KNOW EVERYONE’S IMMIGRATION STATUS WHO IS APPLYING TO DETERMINE THEIR LEVEL OF ELIGIBILITY AND TO HELP THEM GET THE HELP THAT THEY’RE ENTITLED TO. IMMIGRATION STATUS IS MADE UP OF DIFFERENT CATEGORIES. WE’VE PROVIDED HELP TEXTS TO PROVIDE THE CONSUMER WITH A GUIDE AS TO WHICH CATEGORY THEY SHOULD SELECT IN THIS QUESTION. WE ALSO ASK ABOUT RACE AND ETHNICITY. WHILE THESE QUESTIONS ARE OPTIONAL, ANSWERING THEM CAN HELP US SERVE COMMUNITIES BETTER. GIVING THIS INFORMATION WILL NOT AFFECT A CONSUMER’S ELIGIBILITY, PLAN CHOICES, OR ACCESS TO PROGRAMS. WE THEN ASK ABOUT PREGNANCY, AMERICAN INDIAN/ ALASKAN NATIVE STATUS, AND DISABILITY STATUS. WE’RE GONNA SAY JOSEPHINE IS NOT PREGNANT. AMERICANS INDIANS AND ALASKA NATIVES RECOGNIZED BY THE U.S. GOVERNMENT MAY QUALIFY FOR SPECIAL HEALTHCARE COST SHARING AND SPECIAL ENROLLMENT PERIODS. FOR OUR EXAMPLE, JOSEPHINE IS NOT AN AMERICAN INDIAN. WE ASK ABOUT DISABILITY QUESTIONS SO THAT IF SOMEONE IS DISABLED OR BLIND, THEY CAN GET ADDITIONAL HELP THROUGH THE LOCAL DEPARTMENTS OF SOCIAL SERVICES. IN OUR EXAMPLE, WE’RE GONNA SAY THAT JOSEPHINE IS NOT CLAIMING A DISABILITY. WE ASK SIMILAR QUESTIONS FOR MARVIN. WE’RE GONNA SAY MARVIN IS NOT SINGLE. WE’RE GOING TO ENTER IN MARVIN’S DATE OF BIRTH. THEN WE ASK ABOUT HIS SOCIAL SECURITY NUMBER. WE ASK FOR SOCIAL SECURITY NUMBER FOR EVERYONE THAT HAS ONE AND IF THEY ARE APPLYING FOR HEALTHCARE COVERAGE. PROVIDING THEIR SOCIAL SECURITY NUMBER CAN BE HELPFUL, EVEN IF THEY DON’T WANT HEALTHCARE COVERAGE, AS IT CAN SPEED UP THE APPLICATION PROCESS. IF MARVIN DIDN’T HAVE A SOCIAL SECURITY NUMBER, HE COULD CLICK ON “I DON’T HAVE ONE” AND THEN SELECT YOUR REASON WHY HE DOESN’T HAVE A SOCIAL SECURITY NUMBER. THERE ARE RULES IN OUR ONLINE APPLICATION THAT MAY ALLOW MARVIN TO CONTINUE WITH THE APPLICATION PROCESS. IN OUR EXAMPLE, MARVIN DOES HAVE A SOCIAL SECURITY NUMBER. HE ANSWERS THE SAME QUESTIONS ABOUT CITIZENSHIP AND IMMIGRATION STATUS AND RACE AND ETHNICITY. AND THEN GETS THE SAME AMERICAN INDIAN/ ALASKAN NATIVE QUESTIONS, QUESTIONS ABOUT DISABILITY, AS WELL AS RECENT MEDICAL EXPENSES. WE THEN GO ON TO SELECT THE RELATIONSHIPS OF ALL THE MEMBERS IN THE HOUSEHOLD. THE RELATIONSHIPS HELP US LEARN WHO’S IN THE HOUSEHOLD SO THAT WE CAN FIND A HEALTH PLAN THAT ALL THE HEALTH MEMBERS CAN JOIN. ONE OF THE REQUIREMENTS OF PURCHASING A HEALTH PLAN THROUGH THE MARKETPLACE IS THAT YOU HAVE TO BE A RESIDENT OF THE STATE OF NEW YORK. THE HOME ADDRESS IS THE MAILING ADDRESS THAT WAS INDICATED IN THE ACCOUNT-CREATION PROCESS. IF SOMEONE ENTERED IN A POST OFFICE BOX IN THE MAILING ADDRESS, THEY WOULD THEN CHANGE IT AT THIS POINT IN THE APPLICATION. PEOPLE NEED TO HAVE A STREET ADDRESS AS THEIR HOME ADDRESS IN THIS PART OF THE APPLICATION. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT BOTH JOSEPHINE AND MARVIN LIVE AT 123 MAIN STREET. AFTER ENTERING IN ALL THE DEMOGRAPHIC INFORMATION, THEY WILL BE ABLE TO REVIEW THE INFORMATION THAT THEY’VE PUT INTO THE APPLICATION SO FAR AND MAKE ANY CHANGES. AFTER REVIEWING THE INFORMATION, THEY WILL CLICK ON THE MARKETPLACE’S POLICIES ON PRIVACY AND INFORMATION ABOUT HOW THE MARKETPLACE WILL USE THE INFORMATION. THEY’RE ABLE TO DOWNLOAD AND PRINT THIS INFORMATION FOR THEIR RECORDS. THE NEXT SET OF SCREENS ASKS FOR INFORMATION ABOUT INCOME. WE ASK ABOUT THE TAX-FILING STATUS OF EVERYONE ON THE APPLICATION FOR THE UPCOMING TAX YEAR. IF SOMEONE IS MARRIED AND WILL FILE JOINTLY, WE ARE ASKING FOR THEM TO SELECT WHO THEY ARE FILING JOINTLY WITH. WE ALSO ASK PEOPLE TO TELL US ABOUT ANY DEPENDENTS WHO THEY PLAN TO CLAIM IN THE UPCOMING TAX YEAR. FOR PEOPLE WHO ARE NOT FILING TAXES, THEY CAN STILL APPLY FOR HELP, PAYING FOR HEALTHCARE COVERAGE THROUGH THE MARKETPLACE. THEY WOULD JUST SELECT ON THE “NOT FILING TAXES” IN THE DROP-DOWN IN THE TAX STATUS MENU. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT JOSEPHINE IS SINGLE AND THAT SHE’S CLAIMING MARVIN ON HER TAXES. WE ALSO WANT TO INDICATE WHAT MARVIN’S TAX-FILING STATUS IS, AS IN CERTAIN CIRCUMSTANCES, DEPENDANTS ALSO HAVE TO FILE TAXES. IN OUR EXAMPLE, MARVIN IS NOT FILING TAXES. JOSEPHINE THEN GETS A QUESTION, ASKING HER IF HER INCOME ON HER UPCOMING TAX RETURN WILL BE THE SAME AS WHAT SHE FILED LAST YEAR. IN OUR EXAMPLE, JOSEPHINE WILL SAY NO, AS SHE IS NOT SURE, AND THEN GO ON TO GIVE US INFORMATION ABOUT HER INCOME. THE FIRST TYPE OF INCOME JOSEPHINE IS ASKED ABOUT IS INCOME FROM A JOB. JOSEPHINE WILL CLICK ON THE “ADD INCOME SOURCE” BUTTON AND ENTER IN EMPLOYER INFORMATION, SUCH AS THE EMPLOYER NAME, ADDRESS, CITY, AND STATE. IF JOSEPHINE WAS SELF-EMPLOYED, SHE WOULD CLICK ON THE “SELF-EMPLOYED” BUTTON, THEN ENTER IN INFORMATION ABOUT REVENUE AND EXPENSES FOR HER SELF-EMPLOYMENT. THE NEXT SCREEN THAT JOSEPHINE GETS IS ASKING WHETHER OR NOT HER INCOME IS STEADY OR INCONSISTENT. BECAUSE SHE RECEIVES A PAYCHECK EVERY MONTH, WE’RE GONNA SAY THAT HER INCOME IS STEADY. SHE RECEIVES $2,900 MONTHLY. FOR MARVIN, WE HAVE TO CHECK THE BOX BY HIS NAME, AS HE WILL NOT BE RECEIVING ANY INCOME FROM A JOB. WE THEN ASK ABOUT INCOME FROM UNEMPLOYMENT BENEFITS. FOR OUR EXAMPLE, JOSEPHINE AND MARVIN DO NOT RECEIVE ANY UNEMPLOYMENT-INSURANCE BENEFITS. THEY ALSO DON’T RECEIVE ANY INCOME FROM SOCIAL SECURITY. THE NEXT SCREEN ASKS ABOUT ADDITIONAL INCOME. TO ADD ADDITIONAL INCOME, THEY WOULD CLICK ON THE BOX MARKED “ADDITIONAL INCOME.” THEY WOULD BE ABLE TO SELECT FROM TYPES OF INCOME THAT ARE REPORTABLE ON THE FEDERAL INCOME TAX AND THEN ENTER IN THE FREQUENCY AND THE AMOUNT THAT THEY RECEIVED THIS TYPE OF INCOME. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT JOSEPHINE AND MARVIN DO NOT HAVE ANY ADDITIONAL INCOME. THE NEXT SECTION ASKS ABOUT DEDUCTIONS THAT JOSEPHINE WOULD BE CLAIMING ON HER UPCOMING TAX YEAR. SIMILAR TO ADDITIONAL INCOME TO ADD A DEDUCTION, THEY WOULD CLICK ON “ADD A DEDUCTION” TO SEE WHAT DEDUCTIONS ARE ALLOWABLE ON THE FEDERAL INCOME TAX, AS WELL AS LOOKING — THEN YOU WOULD TYPE IN THE AMOUNT AND THE FREQUENCY THAT THEY WOULD CLAIM FOR THIS DEDUCTION. JOSEPHINE AND MARVIN HAVE NO DEDUCTIONS. AFTER ENTERING INFORMATION ABOUT INCOME, THEY WILL HAVE AN OPPORTUNITY TO REVIEW ALL OF THE INCOME THAT THEY HAVE PUT INTO THE APPLICATION AND THEN CHECK ON THE BOX THAT THEY AGREE WITH THE AMOUNT SHOWN. THEY WILL THEN GET A SERIES OF QUESTIONS THAT MAY OR MAY NOT BE APPLIED TO THEM. THE NEXT SET OF QUESTIONS HAVE TO DO WITH ENROLLMENT IN HEALTHCARE COVERAGE. THE FIRST QUESTION ASKS WHETHER OR NOT JOSEPHINE IS CURRENTLY ENROLLED IN HEALTHCARE COVERAGE. CONSUMERS SHOULD SELECT NO IF THEY’RE ENROLLED IN ANY KIND OF PUBLIC COVERAGE, SUCH AS MEDICARE, MEDICAID, CHILD HEALTH PLUS, OR VETERANS’ HEALTH PROGRAMS. IF JOSEPHINE WAS ENROLLED IN ANY KIND OF PRIVATE HEALTH INSURANCE, SHE WOULD MARK YES, SELECT THE TYPE OF HEALTH INSURANCE THAT SHE’S CURRENTLY ENROLLED IN, AND THEN ENTER IN INFORMATION ABOUT THAT POLICY. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT JOSEPHINE IS NOT ENROLLED INTO COVERAGE. THE NEXT SET OF QUESTIONS ASKS INFORMATION ABOUT COVERAGE THAT JOSEPHINE COULD GET THROUGH A JOB. IF SHE SAID YES, THAT SHE COULD GET COVERAGE THROUGH HER EMPLOYER, SHE WOULD CLICK ON “YES” AND THEN SEE WHETHER OR NOT SHE’S QUALIFIED TO ENTER IN THE INFORMATION AND THEN ANSWER SOME INFORMATION ABOUT THE DATE THAT SHE’S QUALIFIED, INFORMATION ABOUT THE EMPLOYEE AND EMPLOYER, AS WELL AS WHETHER OR NOT THE COVERAGE IS OF MINIMAL ESSENTIAL VALUE. MINIMUM VALUE STANDARD IS DEFINED AS AN EMPLOYER-SPONSORED HEALTH PLAN THAT MEETS MINIMUM VALUE STANDARD IF THE HEALTH PLAN’S SHARE OF THE TOTAL ALLOWED BENEFIT COSTS COVERED BY THE PLAN IS NO LESS THAN 60% OF THE COST. IF AN EMPLOYER OFFERS SOMETHING THAT’S MINIMUM VALUE STANDARD, THE CONSUMER WILL CLICK “YES” AND THEN ENTER IN THE COST AND FREQUENCY OF PAYMENT. IF THE CONSUMER DOES NOT HAVE THIS INFORMATION READY AND HANDY, THEY CAN ASK THEIR EMPLOYER OR THEIR HUMAN RESOURCES DEPARTMENT FOR THIS INFORMATION. FOR OUR EXAMPLE, WE’RE GOING TO SAY NO TO THIS QUESTION. MARVIN GETS A SIMILAR SET OF QUESTIONS ABOUT BEING ENROLLED INTO COVERAGE. WE’RE GOING TO SAY NO TO MARVIN BEING ENROLLED INTO COVERAGE AND THEN ALSO ASK WHETHER OR NOT MARVIN IS COVERED BY A PUBLIC EMPLOYEE PLAN. WE’RE GONNA SAY NO TO THAT. MARVIN HAS NOT LOST ANY COVERAGE IN THE LAST THREE MONTHS AND CANNOT GET COVERAGE THROUGH A JOB, SUCH AS THROUGH A PARENT OR SPOUSE. AND THEN WE’RE GONNA CLICK ON THE NEXT BUTTON. AFTER ENTERING ALL OF THE INFORMATION, WE GET ONE LAST CHANCE TO REVIEW ALL OF THE INFORMATION, INCLUDING THE DEMOGRAPHIC INFORMATION, THAT THE CONSUMER HAS ENTERED INTO THE APPLICATION. AFTER REVIEWING THE INFORMATION AND CLICKING ON THE “NEXT” BUTTON, THE CONSUMER WILL READ THE TERMS, RIGHTS, AND RESPONSIBILITIES AND CHECK THE BOX AT THE BOTTOM THAT SAYS THAT THEY AGREE WITH THE INFORMATION THAT THEY’VE PUT INTO THE APPLICATION. JOSEPHINE WOULD THEN INITIAL THE APPLICATION… …AND THEN CLICK ON THE “FINISH” BUTTON IN ORDER TO GET AN ELIGIBILITY RESULT. THE CONSUMER IS ALSO ABLE TO DOWNLOAD AND PRINT THE TERMS, RIGHTS, AND RESPONSIBILITIES, AND THERE’S ALSO INFORMATION ABOUT THE RENEWAL PROCESS FOR CONSUMERS WHO ARE RECEIVING FINANCIAL ASSISTANCE. THIS INFORMATION CAN BE USED TO RENEW COVERAGE ON AN ANNUAL BASIS. WE CAN SEE THAT JOSEPHINE IS ELIGIBLE FOR AN ADVANCED PREMIUM TAX CREDIT WITH A COST-SHARING REDUCTION. HER ADVANCED PREMIUM TAX CREDIT IS $144 PER MONTH, AND HER COST-SHARING REDUCTION — HER MAXIMUM OUT-OF-POCKET COSTS WOULD BE $4,000 PER YEAR. MARVIN IS ELIGIBLE FOR CHILD HEALTH PLUS WITH A PREMIUM OF $15 PER MONTH. THE NEXT STEP IN THE PROCESS IS TO SELECT A PLAN FOR MARVIN AND JOSEPHINE. IN THIS SECTION, BOTH JOSEPHINE AND MARVIN WILL BE ABLE TO PICK A PLAN FOR THEMSELVES, WHETHER THEY QUALIFY FOR MEDICAID, CHILD HEALTH PLUS, OR A PLAN OFFERED THROUGH THE MARKETPLACE. WE’RE FIRST GONNA START BY PICKING A PLAN FOR JOSEPHINE. ON THIS PAGE, YOU WILL BE ABLE TO SELECT A PLAN FOR ALL OF THE FAMILY MEMBERS LISTED BELOW. THEY WILL BE ABLE TO SELECT ONE OF THE FOLLOWING TYPES OF PLANS FOR EACH FAMILY MEMBER — A MEDICAL PLAN THAT DOES NOT INCLUDE DENTAL COVERAGE, A MEDICAL PLAN THAT DOES INCLUDE DENTAL COVERAGE FOR ALL FAMILY MEMBERS, AND A MEDICAL PLAN THAT INCLUDES MEDICAL COVERAGE AND DENTAL FOR ONLY CHILDREN. YOU’RE ABLE TO SORT BY THE TYPE OF PLAN… …BY CLICKING ON THE “TYPE” BUTTON. SO HERE WE SEE THAT THESE PLANS ARE MEDICAL TYPES OF PLANS. YOU CAN ALSO SORT BY META LEVEL, AS WELL AS BY THE AMOUNT THAT YOU WOULD PAY. YOU CAN ALSO FILTER THESE PLANS. IF YOU WANTED TO SEE A CERTAIN SUBSET OF PLANS, YOU COULD SORT BY PREMIUM, META LEVEL… CARRIER NAME, AS WELL AS IF YOU WANTED TO SEARCH FOR A DOCTOR THAT WAS IN A NETWORK FOR A PLAN. AND YOU CAN ALSO SEARCH BY QUALITY RATINGS. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT JOSEPHINE WANTS TO LOOK AT ONLY SILVER-LEVEL PLANS. SO HERE ARE THE PLANS THAT ARE AVAILABLE TO JOSEPHINE THAT MEET HER SEARCH CRITERIA. JOSEPHINE COULD ADJUST THE AMOUNT OF HER ADVANCED PREMIUM TAX CREDIT. BY USING THE SLIDER, SHE CAN DECREASE THE AMOUNT THAT SHE WANTS TO TAKE PER MONTH, AND IT WILL THEN SHOW THE AMOUNT OF THE PREMIUM CHANGE, DEPENDING ON HOW MUCH SHE CHOOSES TO TAKE EACH MONTH. JOSEPHINE CAN ALSO LOOK AT THE DETAILS FOR EACH PLAN AND CAN SEE WHAT BENEFITS ARE OFFERED, INCLUDING THE MONTHLY PREMIUMS… AND WHAT HER OUT-OF-POCKET COSTS WOULD BE FOR THESE BENEFITS. SHE’S GONNA GO BACK TO THE PLAN PAGE TO SEE ALL OF THE PLANS THAT ARE AVAILABLE TO HER, AND THEN SHE’S GOING TO SELECT… SHE’S GOING TO SELECT THE SILVER PLAN THAT’S $293. NOW WE’RE GOING TO GO ON TO PICK A PLAN FOR MARVIN. HE’S GOING TO PICK A CHILD HEALTH PLUS PLAN. MARVIN IS ABLE TO SORT THE PLANS THAT ARE AVAILABLE TO HIM BY CARRIER NAME, DOCTOR OR FACILITY, AND QUALITY RATING. FOR OUR EXAMPLE, WE’RE GOING TO SAY THAT MARVIN IS GOING TO CHOOSE THE CDPHP PLAN. AFTER SELECTING PLANS FOR EVERYONE IN THE HOUSEHOLD, THE CONSUMER WILL THEN BEGIN THE CONFIRMATION AND CHECKOUT PROCESS. JOSEPHINE HAS AN OPPORTUNITY TO REVIEW THE PLANS THAT SHE’S SELECTED AND THE AMOUNT OF HER ADVANCED PREMIUM TAX CREDIT THAT SHE HAS CHOSEN TO TAKE FOR THE YEAR. SHE CAN DECREASE THE AMOUNT THAT SHE’S TAKEN AND WILL SEE HOW HER MONTHLY PREMIUM WOULD BE AFFECTED. SHE ALSO THEN READS THE INFORMATION ABOUT FILING TAXES FOR THE UPCOMING TAX YEAR AND THEN INITIALS IT AT THE BOTTOM. THIS CONSENT ALSO INFORMS JOSEPHINE THAT IF SHE HAS ANY KIND OF CHANGES TO HER INCOME OR TO HER HOUSEHOLD COMPOSITION THAT SHE NEEDS TO REPORT IT TO THE MARKETPLACE. SHE’S THEN GOING TO CONFIRM AND CHECK OUT. THIS IS THE CONFIRMATION PAGE THAT JOSEPHINE WILL SEE ONCE SHE HAS CHECKED OUT AND HAS SELECTED PLANS FOR BOTH HERSELF AND MARVIN. SHE GETS INFORMATION ABOUT HER TRANSACTION NUMBER, AS WELL AS THE CUSTOMER-SERVICE NUMBER OF HER PLAN AND THE HEALTH PLAN WEBSITE. FOR CHILD HEALTH PLUS, SHE GETS A TRANSACTION I.D. NUMBER AND MORE INFORMATION ON WHERE TO PAY THE FIRST MONTH’S PREMIUM. JOSEPHINE HAS THE OPPORTUNITY TO PRINT THIS PAGE FOR HER RECORDS, AND THEN SHE IS DONE WITH THE ENROLLMENT PROCESS. THIS ENDS OUR DEMONSTRATION, AND WE LOOK FORWARD TO SEEING EVERYONE AT THE MARKETPLACE ON OCTOBER 1st. THANK YOU.