Outline of Health Connector and Mixed Household Redeterminations, - - PDF document

outline of health connector and mixed household
SMART_READER_LITE
LIVE PREVIEW

Outline of Health Connector and Mixed Household Redeterminations, - - PDF document

Outline of Health Connector and Mixed Household Redeterminations, Renewals, and Release 9.0 conference call recording. Welcome to the Health Connector and Mixed Household Redeterminations, Renewals, and Release 9.0 conference call.


slide-1
SLIDE 1

Outline of “Health Connector and Mixed Household Redeterminations, Renewals, and Release 9.0” conference call recording. Welcome to the “Health Connector and Mixed Household Redeterminations, Renewals, and Release 9.0” conference call. . (Slide 1 Title Slide) - Health Connector and Mixed Household Redeterminations, Renewals, and Release 9.0. August 2016 (Slide 2) - Agenda

 Health Connector and Mixed Household Redeterminations and Renewals  Release 9.0 Functionality

(Slide 3 Title Slide) - Health Connector and Mixed Household Redeterminations and Renewals (Slide 4) - Redeterminations & Renewals: Overview

Open Enrollment is the time of year when individuals and families may enroll in non-group coverage

  • r switch existing Health Connector coverage for any reason, without needing a qualifying event

 Open Enrollment is November 1, 2016- January 31, 2017 − Health Connector members can begin shopping and make new plan selections

  • n November 1, but any new plan selection will not be effective until January 1, 2017

− New applicants can submit applications and enroll for coverage starting January 1, 2017 without experiencing a qualifying event. If new members would like coverage in 2016, they must have a qualifying event − Any Health Connector members enrolled in 2016 will be redetermined and renewed into a plan for 2017 − As a reminder – people can apply for and become eligible for MassHealth, the Health Safety Net, or Children’s Medical Security Plan at any time during the year

(Slide 5) - Redeterminations & Renewals: Overview

The federal government requires that each year, individuals in Marketplaces have their eligibility redetermined and have their QHPs/QDPs renewed Redetermination: Eligibility Annual process for a Marketplace to reassess an individual’s eligibility for enrollment in or financial assistance paying for a Qualified Health Plan (QHP)/Qualified Dental Plan (QDP) by proactively reviewing federal data and requesting new information from a customer whose prior eligibility information does not reasonably match any new information obtained. Renewal: Enrollment Process outlined by federal regulations that guarantees that eligible QHP/QDP enrollees be renewed into coverage for the following coverage year if they are still eligible. Includes guidelines on how to

slide-2
SLIDE 2

provide a like-plan for members in a mapping scheme in the event their same plan is not available or if their eligibility has changed.  Given unique features of our market – most notably the ConnectorCare program–we use a state-specific approach to redeterminations and renewals that has been approved by Centers for Medicare & Medicaid Services (CMS)

(Slide 6) - Redeterminations & Renewals 2017

There are three key updates for the 2017 annual redeterminations and renewals process:

  • 1. Verified FPL – Using Internal Revenue Service (IRS) income data for renewals if an individual has

not manually verified during 2016 and current income is not compatible with IRS data.

  • 2. Failure to Reconcile – Use a system process to find out if individuals have not properly filed or

reconciled their premium tax credits.

  • 3. New process for Mixed Households (both Health Connector and MassHealth eligible

individuals).

(Slide 7) - Redeterminations & Renewals: Overview

OE 2016 Checked federal data sources for:

  • Public minimum essential coverage (MEC),
  • Death,
  • Disability, and
  • Failure to reconcile (FTR)
  • Only a limited number of individuals received tax credits in 2014, so the impact during

Open Enrollment was small Did not use Federal data sources for income (because every member updated income within the past year) OE 2017 Checking federal data sources for:

  • Public minimum essential coverage (MEC),
  • Death,
  • Disability,
  • FTR, and
  • Income
  • This is the first time the Health Connector is using income as part of the redeterminations and

renewals process New Process Mixed Households

(Slide 8) - Redeterminations & Renewals 2017

Mixed Household Process

  • Mixed households are households with any individuals with a Health Connector

determination (regardless of enrollment) and a MassHealth determination (other than a Health Safety Net wrap)

  • MassHealth members in mixed households will be processed as part of Health Connector

redeterminations

slide-3
SLIDE 3
  • A new joint notice for mixed households with Health Connector members who are sent a

pre-populated form will provide one central location for members to find information about renewals

(Slide 9) - Redeterminations & Renewals 2017

Mixed Household Process

  • If there are MassHealth members in the household, that household may have to take

action to maintain MassHealth benefits

  • Households with enrolled Health Connector members who cannot be renewed into the

same benefits using federal or state data sources will receive a prepopulated renewal form and special joint cover letter

  • Households without enrolled Health Connector members will receive a regular MassHealth

renewal cover letter and prepopulated form cover letter for their household, just as they do today

(Slide 10) - Redeterminations & Renewals 2017

Using State and Federal Data Sources for Income

  • The Health Connector and MassHealth (for members in mixed Households) will be checking

members’ income against available state and federal data sources unless income was manually verified within the year (August 2015-August 2016)

  • If a member’s income was not manually verified during the current year, the member’s

self-attested income will be checked against the income available from federal data sources

  • If MassHealth members in mixed HH’s do not respond to their renewal within 45-days,

MassHealth will use federal and state data sources in order to determine what benefit the member will qualify for. This is the same process that MassHealth does for MassHealth-

  • nly members who are renewed through the HIX

(Slide 11) - Redeterminations & Renewals 2017

Using State and Federal Data Sources for Income

  • When using state and federal data sources:
  • If the Health Connector member’s self-attested income is higher, the self-attested

income is used for 2017 eligibility

  • If the self-attested income is lower, the Health Connector determines if it is reasonably
  • compatible. If reasonably compatible, the Health Connector uses the self-attested

income for 2017 eligibility. If not reasonably compatible, the Health Connector uses the data available from federal data sources

  • If no income is available with state or federal sources the member will be determined

eligible for an unsubsidized QHP

(Slide 12) - Self-Attested Income vs. Federal/State Income

Use Self-Attested Income If…

  • Income for everyone in the household was manually verified between August 2015-August

2016 OR

  • Income wasn’t manually verified, BUT…
  • Attested FPL is reasonably compatible with Verified FPL

Use Federal/State Income Data If…

slide-4
SLIDE 4
  • Income wasn’t manually verified, AND…
  • Attested FPL is NOT reasonably compatible with Verified FPL
  • If no IRS data is available, household gets unsubsidized coverage

(Slide 13) - Redeterminations & Renewals 2017 (cont’d)

Failure to Reconcile

  • If a Health Connector member does not properly file or reconcile their taxes after receiving

tax credits in 2015, the member will be blocked from receiving subsidies in 2017. This is known as failure to reconcile (FTR)

  • In 2015, a substantial number of members received premium tax credits for the first time in
  • Massachusetts. Filing and reconciling taxes was a new process for many Health Connector

members this year

  • The Health Connector is not allowed to reveal federal tax information to members.

Therefore, if a member is blocked from subsidies because of FTR, the Health Connector cannot directly tell the member that this is why subsidies are not available for 2017

  • Individuals who did not file in 2015 will likely see their eligibility change online at the end of

September when IRS updates their records. Members will see their resulting changes in their October Notice

(Slide 14) - Redeterminations & Renewals 2017

Health Connector members without social security numbers (SSNs) will become eligible for an unsubsidized QHP

  • The Health Connector and MassHealth are unable to check federal data sources for

members without SSNs

  • Members can update their SSN or 2017 application information if they are seeking

subsidies Picture of Online Eligibility Results and 2017 Application Summary This picture displays the 2017 eligibility results for a member without a social security number. The pictures shows a member with ConnectorCare in 2016 and Health Connector Plans (no financial assistance) in 2017. The application summary shows that the member does not have a social security number.

(Slide 15 Title Slide) - Health Connector and Mixed Households Redeterminations and Renewals Noticing and Communications (Slide 16) - Redeterminations & Renewals: Communications and Notice

 The Health Connector will only be noticing and renewing individuals who are actively enrolled in a 2016 Qualified Health Plan (QHP) or Qualified Dental Plan (QDP) leading up to or during Open Enrollment

  • Note – Mixed Households will receive a unique cover letter (with instructions)

and a prepopulated renewal form. This is similar to the letters that MassHealth currently sends to members who are having their benefits redetermined in the HIX today Preliminary Eligibility Notice

  • Late August-early September
  • Sent to enrollees who submitted a subsidized application
  • Informs them of estimated 2017 FPL and program eligibility
slide-5
SLIDE 5
  • Instructs on how to update/correct the information
  • Encourages updating the 2017 eligibility application

Renewal Notice

  • Late October (right before Open Enrollment)
  • Sent to all enrollees eligible to renew into a QHP and/or a QDP in 2017
  • Includes information about the member’s 2017 plan (including QDPs, where applicable), rates,

tax credit amount (where applicable), other plan options for ConnectorCare eligible members and other helpful information related to Open Enrollment

(Slide 17) - Redeterminations & Renewals: August Communications

Preliminary Determination Notice

  • Members have 30 days to report changes before the Health Connector makes a final

eligibility determination for 2017 Picture of Renewal Handout and List of things to do The left-hand picture shows the image of a letter that members will receive about renewing 2017

  • coverage. This letter includes important dates for 2017 Open Enrollment. The right-hand picture shows

the image of a preliminary eligibility notice with instructions about steps to take to update information.

(Slide 18) - Redeterminations & Renewals: August Communications

Picture of Reasons for Non-Eligibility or Eligibility Change These two pictures show the preliminary eligibility notice. It includes information the member will see about their current and expected 2017 eligibility. There is also a list of reasons outlining why a member may have lost subsidies, including an income or family size change, access to other health insurance, or failure to reconcile tax credits.

(Slide 19) - Redeterminations & Renewals: Mixed Households

Mixed Household Notice

  • For preliminary eligibility, Mixed Households will receive one of two types of notices
  • If the household has a QHP enrolled member, they will receive a joint cover letter and a

prepopulated form (if they cannot be automatically renewed into the same or better MassHealth benefit)

  • If the household has QHP unenrolled members, the household will receive a MassHealth

renewal notice and prepopulated renewal form (if they cannot be automatically renewed) Picture of Important Notice Message This picture outlines the mixed household notice. It includes information about renewing MassHealth coverage as well as Health Connector coverage information.

(Slide 20) - Redeterminations & Renewals: Mixed Households

Mixed Household Notice

  • Mixed households will have 45 days to review their application (online or on the

prepopulated form) and make any changes before their renewal eligibility is finalized

  • Households with MassHealth members who are sent a prepopulated form will be required

to respond to MassHealth to provide updated information (or else the MassHealth members risk downgrade or potential loss of coverage) online, by phone, or by paper

  • Mixed Households should respond to the renewal for the current (2016) year
slide-6
SLIDE 6

Picture of Eligibility Notice Forms The left-hand picture shows the image of the mixed household notice that the MassHealth member will see, including member ID. The right-hand picture shows the information a Health Connector member will see, which includes current and expected 2017 FPL and current and expected 2017 program determination.

(Slide 21) - Redeterminations & Renewals: October Communications

Renewal Notice

  • Health Connector members will receive a final determination before Open Enrollment
  • Health Connector members can still make updates to their 2017 application after they

receive their renewal notice if their eligibility looks incorrect before the January 1 effective date

  • Health Connector members can also make changes to their 2016 application throughout

2016

  • MassHealth members will receive a notice letting them know what programs they are

eligible for. If a MassHealth member did not respond to the renewal request, the system will use state and federal data sources to determine what benefits the individual may be eligible for Picture of Renewal To Do List This picture is an image of the Health Connector renewal notice. It includes information about how to shop for plans and important Open Enrollment dates.

(Slide 22) - Redeterminations & Renewals: October Communications

Renewal Notice Picture of Health Insurance Renewal Information This picture is another image of the Health Connector renewal notice. It includes information about the member’s current and 2017 program eligibility, current and 2017 health plan enrollment, whether the plan enrollment is the same plan for 2017, and the coverage effective date.

(Slide 23) - Timeline

Picture of timeline This is an image of the timeline related to the Open Enrollment and the redetermination and renewal. It shows that preliminary eligibility notices are sent in late August/early September, that renewal notices are sent in late October, Open Enrollment begins on November 1, final eligibility occurs in December, and the payment due date is December 23rd for January 1 coverage.

(Slide 24 Title Slide) - New Functionality for 2017 Open Enrollment (Slide 25) - New Functionality

Members will see a 2017 application starting after August 23rd

  • The 2017 application is available under the My Eligibility tab
  • The application will display the 2017 FPL and the Program Eligibility
  • A message will display on the My Eligibility page, indicating the system used electronic

data sources for determination since the user did not respond, for all determinations where the user did not respond and final eligibility is determined

slide-7
SLIDE 7

Picture of Online Application Status This image displays the 217 application the member will see that will be available after August 23rd.

(Slide 26) - New Functionality (continued)

  • If the consumer tries to change the current year plan any time after preliminary

eligibility determination, a warning message will indicate that if they select a new current plan, they will have a change in enrollment for next year’s coverage based on the new plan purchase

  • If the user is currently enrolled in a frozen plan and elects to shop for next year’s plan, a

warning message will indicate they cannot access this plan again, if they re-shop Picture of Online Warning Messages This top image displays the warning message for changing a plan during the renewals time frame. The bottom image displays the warning message individuals in frozen plans will receive when they shop during the renewals time period.

(Slide 27) - New Functionality (continued)

Changes to Health Connector shopping and enrollment screens, including:  The ability for new members to select one of the next two available start dates the first time the member shops  Two new fields on the Enrollment and Enrollment Details pages: Picture of chart displaying new and old field names This image displays the old and new names for the Health Connector screens.

(Slide 28 Title Slide) - Assister Role for Helping Consumers during the Redetermination and Renewal Process (Slide 29) - How Can Assisters Help?

Help Members Understand their 2017 Eligibility Determination  Help Members understand the Redetermination and Renewal Process and Important Deadlines  Help Members understand 2017 eligibility determination and help the member understand why their eligibility may have changed  Help mixed households complete their renewal online, by phone, or by returning the prepopulated form to MassHealth  If the Health Connector member lost subsidies, help the member determine why

  • Ask the member if they filed and reconciled their 2015 tax credits
  • Determine if the member manually verified income between August 2015-

August 2016

  • Explain why the Health Connector may have reverted to federal data sources to

make the 2017 preliminary eligibility decision  Help members who lost subsidies

  • Help members to make changes on the 2017 application
  • Remind and assist members to submit any required verifications
  • Refer members to tax assistance locations if the member needs to file taxes

(Slide 30) - Member Questions

slide-8
SLIDE 8

Picture of two people at a table. This image shows two people, one is an assister and one is a member. The member is asking the assister a question about their coverage. Member: Why is there a 2017 application in my online account? Assister: In preparation for Open Enrollment, the system has automatically created a 2017 application for you. Let’s review the 2017 application information and make any necessary changes within 30 days. This will ensure your 2017 eligibility determination is accurate. Please note that if you are a mixed household and received a pre-populated form, you must update your 2016 application.

(Slide 31) - Member Questions

Picture of two people at a table. This image shows two people, one is an assister and one is a member. The member is asking the assister a question about their coverage. Member: Why did I lose eligibility for ConnectorCare in 2017? Assister: There are several reasons that could have caused you to lose ConnectorCare eligibility in 2017. Did you file your 2015 taxes and reconcile your tax credits? If you did not, you must do this in order to keep your subsidies in 2017. Was your income manually verified within the past year? If it was not, the Health Connector checked your income with certain sources, like the IRS. That could have caused a change in your eligibility. If this income does not look right, let’s make an update to your 2017 application and send in copies of your paystubs.

(Slide 32) - Member Questions

Picture of two people at a table. This image shows two people, one is an assister and one is a member. The member is asking the assister a question about their coverage. Member: Do I have to re-enroll for a 2017 plan? Assister: No, if you continue making your premium payments by the 23rd of the month, you will automatically be renewed for 2017 coverage. Pay attention to the payment amount that you will be billed in December, as it may be higher than what you currently pay. If you have a higher premium, I can help you shop for other plans that fit your budget.

(Slide 33 Title Slide) - System Updates – Release 9.0 (Slide 34) - System Updates – Release 9.0

Improvements included in Release 9.0 (effective 8/20/2016) continue to enhance the user experience and make the system easier to use.  Changes included in Release 9.0:

  • System updates to the Health Connector Special Enrollment Period
  • Removing and adding members from an application
  • MassHealth Provisional Eligibility in the online system
  • Reducing duplicate applications
  • Improvements to MassHealth and Health Connector notices
  • System updates to support Health Connector and Mixed Household renewals (covered
  • n previous slides)
slide-9
SLIDE 9
  • USPS address standardization
  • Health Connector eligibility and shopping improvements
  • Updates and improvements throughout the system

The highlights of the improvements and changes that consumers will see are included here. Please refer to the Release 9.0 job aid in the Learning Management System for a more detailed description of R 9.0 enhancements

(Slide 35) - Release 9.0: Special Enrollment Period (SEP)

 The system will not ask applicants to answer questions about life events before showing them their eligibility results

  • If the applicant is automatically eligible for an SEP, that person can begin shopping
  • If the applicant not found eligible for an SEP, a “Can I Shop?” button to proceed to the

SEP questionnaire will appear Screenshot showing “Can I Shop” button highlighted

(Slide 36) - Release 9.0: Special Enrollment Period (SEP)

Updates to Special Enrollment Period (SEP)  A New SEP Decision notice will be triggered after the Qualifying Life Events questionnaire is completed Picture of Special enrollment qualification and steps These two images are the SEP decision notice. The notice outlines whether the applicant is eligible for a SEP and when that SEP eligibility terminates. It also explains how to enroll in a plan and how to send proof of a SEP.

(Slide 37) - Release 9.0: Removing and Adding Members to an Application

New fields on the “Who is Applying for Health Insurance?” page asks members to provide a reason and date when removing household members  When a member is reporting a change (RAC) and selects “Remove Family Member” the member needs to complete:

  • the reason for removing the family member
  • Death, Divorce (including annulment/legal separation), Other, No Longer in

the Household

  • the effective date

 Deceased members will continue to appear on the application but with an indicator saying they are deceased  The “Add Member” question has been moved from the Qualifying Life Events page to the Who is Applying for Health Insurance? page. Adding a member due to birth or marriage will no longer require answering the SEP questionnaire, but individuals will still be required to send proof of the event

(Slide 38) - Release 9.0: Removing Members from an Application (continued)

 When a member is being removed for death, that member will continue to appear with (deceased) beside their name throughout the rest of the application:  For all reasons except Death, the individual will be removed from the system permanently

slide-10
SLIDE 10

 The member will see a warning message indicating that removing this member might have an impact on the household’s eligibility  Reminder: The Head of Household (HoH) cannot be removed from the application. To change or remove the HoH, call customer service or submit a new application for the household Screenshot shows list of household members. One member, Erwin Abc, has (deceased) beside their name.

(Slide 39) - Release 9.0: Removing Members from an Application (continued)

 When a member is being removed due to death, the following warning message will appear: Image showing information below: Warning [red triangle with exclamation point in middle] When you remove a member of your household from your application, they will no longer be eligible for your health or dental plan. However, when you remove a member because they’ve died, they will still be counted as part of your household size and income for this year. This is why you will still see questions about their income in the application.

(Slide 40) - Release 9.0: Removing Members from an Application (continued)

System functionality for removing a member from the household MassHealth Household Composition Rules − If the MassHealth Household was created using tax filer rules, the deceased members income will not be counted but they will still be included in the HH size − If the MassHealth Household was creating using Non-Filer rules, the deceased members income will be included and they will continue to be included in the HH size − A deceased individual counts in MassHealth Household composition, but not in MassHealth income calculation, while determining other members' Medicaid household if the other member(s) in the household is/are fall into tax filing rules for the same calendar year − A deceased individual will not count in MassHealth income calculation and MassHealth Household composition, while determining other members' MassHealth Household, if the other member(s) in the household is/are non-filer(s) for the same calendar year − A deceased individual will not count in the Premium Billing Family Group composition for the calendar year − A deceased individual will remain in the tax household for Health Connector households for the tax year in which the death occurred. Applicants should review the income screen, though, to ensure that projected income reflects any change in expected income due to the death

(Slide 41) - Release 9.0: MassHealth Provisional Eligibility in the Online System

With R 9.0, the system now manages the MassHealth Provisional Eligibility period process. The following information and reminders around MassHealth Provisional Eligibility regulations [130 CMR 502.003] will help Assisters understand how these regulations may impact consumers you assist  MassHealth Provisional Eligibility Reminders

slide-11
SLIDE 11
  • MassHealth Provisional Eligibility regulations allow for up to a 90 day provisional

eligibility period, while the applicant provides any outstanding verification

  • During the provisional eligibility period, MassHealth will accept self-attestation for all

eligibility factors, and make an eligibility determination as if the applicant had supplied the documentation

  • Exception: MassHealth does not accept self-attestation of disability. Disability

must be verified through Social Security Administration (SSA), Massachusetts Commission for the Blind (MCB) or Disability Evaluation Services (DES)

  • Only one provisional benefit will be granted in a one year period for full MassHealth

coverage types (MassHealth Standard, CommonHealth, CarePlus and Family Assistance)

  • Exception: If pregnant, individual may be eligible for a second provisional period

(Slide 42) - Release 9.0: MassHealth Provisional Eligibility in the Online System (continued)

 MassHealth Provisional Eligibility Reminders, continued

  • If the individual does not reply to the RFI in the 90-day time frame, the system will

attempt to determine if the individuals on the application are eligible for benefits based

  • n data sources (if available). Eligibility will be re-determined, and this redetermination

may result in a downgrade or potential termination of benefits. If no data from electronic data sources is available, eligibility is terminated

  • If an individual who has already received one provisional period within the last twelve

months reports changes or submits verifications and at least one outstanding RFI(s) remains unverified, the system will keep the individual in the existing benefit until all

  • utstanding RFIs have been verified
  • Exception: If pregnant, individual may be eligible for a second provisional period
  • In determining if the individual has received provisional within the last twelve

months, the system will look exactly one year from when the first MassHealth provisional period started for the individual

(Slide 43) - Release 9.0: MassHealth Provisional Eligibility in the Online System (continued)

 If a member is eligible for a second provisional period (e.g., is pregnant), applicable notices will be sent

  • If a member is not eligible for a second provisional period, an RFI notice will be sent that

informs the household about their current coverage and what may happen to their coverage if they provide proof

  • No MassHealth eligibility notices will be sent, with the exception of an RFI, if a member

is not eligible for a second provisional period  Additional information about MassHealth Provisional Eligibility and RFI generation and expiration rules can be found in the Learning Management System, Course 6 – Verifications and Yearly Reviews  Start dates of eligibility determinations when all RFIs are received:

  • Once all verifications are received, the date of the most recently received verification

will be used to determine the start date of eligibility

  • When an individual submits a document(s) in response to an RFI and eligibility is re-run:
  • The system will use the date the document was received to determine the

MassHealth coverage start date

  • If more than one RFI was outstanding, when the last document is received, the

Document Receive Date for that document will be used by the system to determine the MassHealth coverage starting date

  • The eligibility start date will be 10 days prior to the latest document receive

date

slide-12
SLIDE 12

(Slide 44) - Release 9.0: Reducing Duplicate Applications

R9.0 includes system improvements to prevent duplicate applications (e.g., more than one application for the same household, a member appearing on more than one application) in the system. Changes include:  The system will use the following fields to check for duplicates:

  • Social Security Number (SSN) or, if there is no SSN
  • First Name, Last Name, and Date of Birth

 The check is done at the end of the Family and Household section of the online application  The following message will display when an individual with matching information is found in the system: Image showing information below: Warning! You cannot continue with your application because some people on your application have already applied for health coverage through the Health Connector or MassHealth. To continue with your application, call either the Health Connector or MassHealth. You can call Health Connector Customer Service at 1-877-MA-ENROLL (1-877-623-6765), or TTY 1-877- 623-7773 for people who are deaf, hard of hearing, or speech disabled. Call MassHealth Customer Service at 1-800-841-2900, or TTY: 1-800-497-4648 for people who are deaf, hard of hearing, or speech disabled.

(Slide 45) - Release 9.0: Reducing Duplicate Applications (continued)

 Assisters who experience the duplicate message while helping a consumer should:

  • Keep the warning message up on the screen and call customer service
  • Customer Service may need more information from the consumer as they research
  • If customer service is able to resolve the duplicate, close the warning message, log out
  • f the application, and log back in to continue

 If a duplicate person is identified on a paper application and appropriate documentation/information has been received, the application will be processed  The system will not check for duplicates if:

  • Household is in a renewal period
  • The duplicate exists in an application that is no longer active
  • The individual is being added to an existing application (Report a Change)
  • The household member is not applying
  • The individual is applying for unsubsidized coverage

(Slide 46) - Release 9.0: Improvements to MassHealth and Health Connector Notices

Improvements to MassHealth and Health Connector Notices in R 9.0:  The following notices will now be available in Spanish:

  • Standard – Approval
  • Standard + Medicare Buy-In – Approval
  • CommonHealth – Approval
  • Family Assistance – Approval
  • CarePlus – Approval
  • Limited
  • CMSP Only
slide-13
SLIDE 13
  • HSN
  • Mixed HH renewal

 Some text in certain Health Connector Spanish notices was appearing in English (e.g., the date, the denial/termination reason). These notices now contain all Spanish text  Mixed households, those that have both MassHealth and Health Connector members, will now receive one renewal letter for the household

(Slide 47) - Release 9.0: USPS Address Standardization

With Release 9.0, the system will check addresses using United States Postal Service (USPS) Address Standardization  Address standardization helps to improve the quality of address information on file with the goal of increasing probability of successful data matching for residency verifications  When a member is entering an address (home or mailing) in the system, it will be matched with what the US Postal Service has on file  Titles for the following field names will change:

  • Current Field Names:
  • Address Line 1 changed to Street Address
  • Address Line 2 changed to Apt./Unit #
  • Zip changed to ZIP Code

When an address doesn’t match the USPS database, a screen will display showing:

  • The standardized address and the option to use the standardized address or the address

the consumer entered

(Slide 48) - Release 9.0: Health Connector Eligibility and Shopping Improvements

Release 9.0 contains updates and improvements to eligibility and Health Connector shopping screens. These improvements include:  Updated language on existing screens to improve clarity and visibility  Improved messaging for confirmations, errors, and warnings

  • New and updated tooltips that provide individuals with more detailed information
  • Updates to certain pages to improve usability and accessibility
  • Updated content to reflect revised business rules and dates
  • Updated links to internal and external webpages to improve ease of navigation and

provide additional information

  • Overall improved consistency throughout the system

(Slide 49) - Release 9.0: Other Updates and Improvements

Updates and improvements included in R 9.0 continue to improve the user experience and make the system easier to use. Highlights of some of the more significant improvements and changes consumers will see include:  A message will display on the My Eligibility page, indicating the system used electronic data sources for determination since the user did not respond, for all determinations where the user did not respond and final eligibility is determined  When an individual is no longer eligible for a MassHealth benefit and is now eligible for unsubsidized QHP in the renewal application, the system will set the MassHealth eligibility end date as last day of the current calendar year  On the Eligibility Result screen, the system will display a new Health Connector eligibility effective date field  Additional suffixes will be added to the Suffix field: V and VI

slide-14
SLIDE 14

 On the Citizenship/Immigration Status screen, the Alien Number and Naturalization Number fields will be non-mandatory

(Slide 50) - Release 9.0: Other Updates and Improvements (continued) Other Screen Changes and Updates

 New headings will be added to create separation on the Income Deduction screen to Income Deductions and Additional Income questions  The sum of all deductions from the application will be displayed as Income Deductions on the Income Summary screen  New and updated tooltips provide more detailed information throughout the application