Consumers often need to upload documents to resolve Data Matching Issues (DMIs) and SEP Verification Issues (SVIs). Getting documents uploaded on time ensures your client keeps their subsidy and/or coverage.
The follow-up document reminder email feature ensures that your clients never miss a deadline to upload documents when resolving a DMI or SVI. Clients can also easily upload required required documents directly from the email reminder upon receipt.
In this article we will cover:
DMIs & SVIs
A Data Matching Issue (DMI) occurs in the following 3 situations:
Incorrect or missing information on the client’s application (e.g. SSN missing)
An inconsistency between the client’s Marketplace application and existing information from trusted sources, like IRS databases.
Trusted sources do not have data for the client.
Special Enrollment Periods (SEPs) are certain timeframes outside of the annual Open Enrollment Period (OEP) when a consumer can can enroll in ACA coverage or change ACA plans.
An SEP Verification Issue (SVI) occurs when a Consumer is eligible for an SEP due to a Qualifying Life Event (QLE), such as losing coverage, and is asked to verify they have experienced the QLE.
DMIs & SVIs can happen on HealthCare.gov, HealthSherpa, and anywhere else you may complete Marketplace enrollments.
Consumers typically need to upload documents to resolve DMIs and SVIs.
Follow-up document reminder email
Clients who meet this criteria will receive an email 15, 5, and 1 days before their follow-up deadline:
Their application is active (not cancelled or terminated), and
They have 1 or more follow-up documents in either of these 2 statuses:
Action needed: A follow-up document needs to be uploaded
Insufficient documentation: An uploaded document was determined by HealthCare.gov to be insufficient. View your client's Marketplace Notices to find out exactly why this decision was made
The email will list any follow-ups tasks currently in "Action needed" or "Insufficient documentation" status.
The email signature that displays will match the information associated with your HealthSherpa account.
Consumer's experience when submitting documents
When consumers select the 'Submit documents' button, they will be prompted to verify their identity.
Once the primary applicant has been verified, they will land on the 'Submit documents to secure your coverage' screen. Here, they can view their follow-up tasks.
Selecting 'Upload docs' next to any follow-up task will open a window allowing the consumer to proceed with document upload.
The documents required will vary depending on the type of DMI or SVI that needs to be satisfied, and in some cases it may be necessary to submit multiple documents to resolve a single DMI or SVI.
Each verify page contains a list of acceptable documents the consumer may choose from to satisfy the specific follow-up item in question. Select the document type, find the file on your computer, and upload.
Once a successful upload has taken place, the consumer will see a 'Your document has been uploaded' success message.
The consumer may repeat the upload process as many times as needed (e.g. multiple documents need to be uploaded, documents need to be resubmitted, revised/additional documentation is required).
Customizing the email signature
Agents are able to set up custom branding within the direct marketing link included with their HealthSherpa for Agents account. Any customizations made will apply to the email notification consumers receive.
Agency administrators can also choose to control the email notification customizations at the agency level. To do this, agency administrators should visit their Agency page, and go to the Settings tab. From the Emails section, select the 'View or edit email' button.
This will open a pop-up where you can click to edit the signature. Any edits you make will apply to this email for your direct downline.
You can also choose to utilize custom text within these fields:
[agent_name]
[agency_name]
[agency_phone]
[agent_email]
By utilizing brackets around these fields, the field will populate information that's unique to each agent when sent.
Disabling the email
To disable follow-up document reminder emails for clients, go to the Settings page within your HealthSherpa account and toggle the notification to "Off."
Agency administrators can also choose to control follow-up document reminder emails for clients at the agency level. To do this, agency administrators should visit their Agency page, and go to the Settings tab. From the Emails section, agency admins can choose to allow their direct downline agents to control this setting, or decide to enable or disable this setting for all direct downline agents.
If you choose to enable or disable this setting for all direct downline agents, your downline agents will see a message on their Settings page indicating that their agency administrator has overridden this setting.
Additional Resources
If you are having any technical issues using HealthSherpa, please contact our Agent Support team at (888) 684-1373, at [email protected], or via chat from within your account.