CMS requires agents and brokers to obtain client consent before accessing Marketplace information or assisting with any ACA enrollment activity. This article covers what consent is required, how to document it, and how to send and track consents in MyMFG.
Key Terms
Key Terms
Consumer consent: The explicit permission an agent, broker, or web-broker must obtain from a consumer before accessing their Marketplace application, assisting with enrollment, or making updates to their coverage.
Federally-facilitated Marketplace (FFM): The health insurance Marketplace operated by the federal government through HealthCare.gov.
Enhanced Direct Enrollment (EDE): A CMS-approved process that allows agents, brokers, and web-brokers to complete Marketplace applications and enrollments directly through a partner website without sending consumers to HealthCare.gov.
Broker of Record (BOR) form: A form issued by a carrier or state DOI that an agent or broker can use to document consumer consent.
What Actions Require Consent?
You must obtain consumer consent before taking any of the following actions:
Conducting a search for a consumer's Marketplace application using an approved EDE website.
Helping a consumer apply for Marketplace coverage or financial assistance.
Enrolling a consumer in a Marketplace qualified health plan (QHP).
Checking the status of a consumer's coverage or making updates throughout the year.
How Do I Obtain and Document Consent?
CMS does not require a specific format. You may obtain consent verbally over the phone, electronically via email, or in person, or use a BOR form. Regardless of the method, the consent record must include the name of the individual giving consent, the date consent was given, and the name of the agent, broker, or web-broker receiving consent.
As a best practice, obtain consent in writing and retain the documentation. You must retain consent records for a minimum of 10 years and produce them to CMS upon request.
Verbal consent that is not documented does not satisfy FFM consent requirements. A valid consent record must include a description of the scope, purpose, and duration of the consent; the date consent was given; the name of the consumer; the name of the agent or broker; and a process through which the consumer may rescind the consent.
How Long Does Consent Last?
Consent does not have an automatic expiration date and remains valid unless the consumer revokes it. However, you must obtain fresh consent before conducting a new person search or making updates to a client's Marketplace application, even if you have worked with them before.
What Happens if I Transfer My Book of Business?
If you sell or transfer your book of business, you must inform all affected consumers of the change in NPN. The new agent or broker must obtain fresh consent before working with those clients. Consent given to you does not automatically transfer to another agent or broker. All consent documents must be secured and retained for 10 years.
Can I Log Into a Consumer's HealthCare.gov Account?
No. Consumer consent never authorizes an agent, broker, or web-broker to log into a consumer's HealthCare.gov account for any reason. You are also prohibited from creating a HealthCare.gov account on behalf of a consumer.
The Three ACA Consents in MyMFG
In MyMFG, there are three ACA consents that can be sent digitally to clients via email or text.
ACA Client Access Consent
Gives the client control over who can access their Marketplace information and for what purpose. You cannot legally access or assist with a client's ACA application without this authorization. This consent can be sent from two places: during the quote and enrollment process, or through the Clients tab in the top navigation bar.
During the Enrollment Process:
From the Clients Tab:
ACA Client Eligibility Consent
Allows the client to authorize you to access their personal Marketplace information, assist with completing the eligibility application, and submit information on their behalf. This confirms the accuracy of the submitted data.
Where it appears in MyMFG: During the ACA eligibility application review, before downloading the eligibility notice.
ACA Client Enrollment Consent
Confirms the client agrees to the selected plan and authorizes you to submit the enrollment on their behalf.
Where it appears in MyMFG: After selecting a plan, before submitting the application.
How to Check Consent Status
To verify whether ACA consents have been sent or signed:
Go to the Clients tab in the top navigation.
Select Client Signatures.
Review the consent status under the applicable ACA consent tabs.
Additional Resources
For additional help, please contact Producer Support, which is available by chat directly from your account, by phone at (866) 568-9649, or by email at [email protected].