Here’s an early look at what the health insurance marketplace online application process will look like. A demonstration copy was released for comment by the feds last week. It will be used as the online application for federally-facilitated State Marketplaces and will also serve as the model that may be used by Covered California and other state-operated marketplaces. This application is a big improvement when compared to online applications in use today by health insurance companies and online retailers.
With integrated electronic verification, the information the applicant enters will be integrated with data from other sources including the IRS, Social Security, and the Department of Homeland Security.
Because this application is a dynamic tool, certain questions appear only for appropriate applicants. For example, only female applicants are asked about pregnancy. Another example is that only people between the ages of 18 and 22 are asked if they are full-time students.
Verifying household size is a complex task, but because the application is dynamic, information is requested only once. The applicant must identify anyone on his or her federal income tax return, including spouse, children, and live in partner if they have children together who need health insurance. Tax filing, employment and income information is verified for each household member.
When federal income tax data is available the applicant’s income data from his last federal income tax return in 2012 is already displayed and serves as a reference point to help determine his or her estimated income for the year in which he wants insurance coverage.
Eligibility for Tax-Credit
Once the applicant’s household size and income is known, the system can determine if the applicant is eligible to receive a premium subsidy and cost-sharing reductions to help pay premiums. Next, the applicant is asked whether he or she receives or could receive affordable employer-sponsored coverage through his job. Assuming the applicant does not, the system puts him or her on the path to receive advance payments of the premium tax credit.
The applicant receives congratulations, a list of programs for which he qualifies and what his next steps are. Applicants can print the eligibility page and have their eligibility determination saved to their electronic account. With the application process complete, the applicant can enroll in a qualified health plan and apply his tax credit right away.