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Frequently Asked Questions: ACA

ACA FAQs

Updated over a week ago

Why doesn’t my client qualify for a Tax Premium Credit (aka subsidy)?

Refer to the Federal Poverty Level Chart. Based on client household size if income is below 100% refer client to Dept of Social Services to apply for Medicaid or CHIP. For clients above 400% they are responsible for the full premium cost.

Can a client decline Medicaid & still receive a Tax Premium Credit?

No, if a client is determined to be eligible for Medicaid or CHIP, they are not eligible for any subsidy. Even if they choose to decline coverage.

When using the new ACA QUICK QUOTE feature why are plan options not showing?

Make sure client doesn’t live in a state that participates in a State Based Exchange. Please refer to the state marketplace to quote & enroll client.

What is EDE?

Enhanced Direct Enrollment (EDE) allows agents to quote & enroll ACA plans without being redirected to Healthcare.gov.

Why am I receiving Invalid FFM Access Credentials error message?

For ACA Agents, using the Enhanced Direct Enrollment (EDE) platform CMS requires agents to relink their FFM Account (Portal.CMS.gov) every 12 hours. This ensures only authorized users in good standing are accessing the system.

Does the EDE support all enrollment types?

Yes, we are a full Phase 3 EDE platform.

Who does each of the Phase Support?

Phase 1 allows for:

  • Single applicants

  • Married applicants

  • Non-pregnant applicants

  • Families without step or adopted children

Phase 2 allows for all phase 1 scenarios, as well as:

  • Full-time students

  • Pregnant applicants

  • Non-US citizens

  • Applicants with missing SSN

  • Applicants with different names than what is on their SSN card

  • Incarcerated applicants

  • Stepchildren

  • Applicants previously in foster care

Phase 3 is designed to support all scenarios, meaning it supports all phase 1 & 2 applications, as well as:

  • American Indians

  • Alaskan Natives

  • Married applicants not filing taxed jointly

  • Dependents’ applicants who are not daughters, sons, or spouses

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