Frequently Asked Questions about the ACA

Q. When is the 2018 Plan Year Open Enrollment Period?
A. The plan year 2018 Open Enrollment begins on November 1, 2017, and ends on December 15, 2017.

Q. What is the biggest challenge for agents to expect in the upcoming OEP?
A. There are two big challenges for the upcoming OEP, the first is the lack of metal tier options throughout the country. It’s important to know what carriers will be offering a product in your market and develop your plan accordingly. Working with Agent Pipeline staff can help you contract with the carriers that will be available and also provide you with additional coverage options for your clients. Another challenge for agents will be the shortened window to complete enrollments from 12 weeks to 6 weeks. This means it’s essential for agents to begin marketing now. Discuss marketing efforts with your Regional Sales Director to develop your individualized marketing plan.

Q. Will consumers be able to purchase health insurance year round?
A. Consumers can purchase alternatives to ACA products year-round (e.g., Minimum Essential Coverage and Healthshare Ministry plans), however, your clients can not enroll in a metal tier plan outside of Open Enrollment without first qualifying for a Special Election Period enrollment. Some of the examples of qualifications for a SEP include birth/death, adoption, marriage/divorce, relocation to a new zip code or county, a student moving to/from the place they attend school, changes that make your client no longer eligible for Medicaid or CHIP. You can also learn about more complex issues that may qualify your client for a SEP.

Q. Are there any restrictions on marketing?
A. There are no restrictions on your market these and other under-age individual health plans.

Q. Are there any training(s) I need to complete before I can sell ACA plans?
A. You must complete the state specific or the Federally-Facilitated Marketplace (FFM) training. Click here to find out what training you will need in your resident state. If you sell in multiple states, please remember to check the training requirements for all states in which you wish to sell. It’s important to remember you must register and certify annually. Many states’ Department of Insurance also considers the AHIP’s FFM special training a Continuing Education (CE) credit.

Q. What income is used to determine the subsidy eligibility?
A. MAGI – Modified Adjusted Gross Income. Generally, your modified adjusted gross income (MAGI) is the total of your adjusted gross income and tax-exempt interest income you may have. These are the amounts on lines 37 and 8b of IRS from 1040. Some examples of income are: wages, salaries, tips, taxable interest, certain dividends, business income, capital gains, and unemployment compensation, as well as annuities, Social Security payments and some pensions.

Q. How are commissions calculated?
A. Commission payments vary by company and often on market vs. off market participation. Some carriers are offering a per member per month (PMPM) amount.  We have also been advised some companies are choosing to pay a flat fee per enrollment for the upcoming year.

Q. What are the new rules for Short Term Medical plans?
A. The new rule for short term medical limits plans to three months or less in duration.

Do you have another question? Contact a Regional Sales Director at 800-962-4693 to learn more about the ACA.