Conditional Eligibility Verification (CEV)

Customers who complete an application that cannot be verified for eligibility due to insufficient information related to income, citizenship, Social Security number, etc., may be eligible to enroll in a QHP with a “Conditional Eligibility.”Customers whose eligibility is conditional have 90 days to submit the requested documentation.

HBE’s Conditional Eligibility Verification team has begun reviewing and redetermining eligibility for customers who:

  1. Did not submit documents necessary to verify eligibility; or
  2. Submitted documents that are insufficient to verify what was reported in the application.

What this means? Customers who enrolled in November 2016 and who and have not submitted documentation have missed the deadline to respond. HBE is re-determining eligibility and taking appropriate action. The action taken depends on the nature of the documentation needed. In the case of an income discrepancy, it could result in a loss or reduction of tax credits, or in the case of citizenship or legal status, it could mean coverage is terminated. The effective date of the action is 90 days from the conditional eligibility date. Customers are being notified as the reviews and re-determinations are completed.

What can you do to help the customer? When a customer disagrees with the Exchange’s decision to fail their eligibility, please email and we'll submit a Zendesk ticket for review. The Conditional Eligibility Verification team will contact the customer within 1-2 business days to follow-up.

What is going to happen on a regular basis in the future? From this point forward, HBEwill be conducting the reviews and re-determinations on an ongoing basis.

Navigator/Broker Help Session

Conditional Eligibility VerificationonMar 28, 2017 12:10 PM PDTat:

Our guest speaker will be Margaret Eby, the Associate Director of Eligibility, Appeals & Review at the Washington Health Benefit Exchange. Margaret will talk about what a customer can expect when they are found conditionally eligible and are asked to provide documents in Washington Healthplanfinder.
1095-A Tax Form Errors and Corrections

If something doesn’t seem correct on your 1095-A, you can use this link to submit a correction request online.

Correction requests need to be submitted by April 11, 2017 for a timely response fromWashington Healthplanfinder. Correction requests submitted afterApril 11, 2017 will be reviewed as quickly as possible; however,we can’t guarantee a response by the tax filing deadline of April 18, 2017.

Please note:

  • Customers don’t need to submit a correction request if their name or a household member’s nameis spelled incorrectly, or if an incorrect physical address is listed on their 1095-A. This information can be updated when they file their tax return.
  • Any changes to their household size can be updated using Form 8962.

Customers should use the information on their 1095-A to complete tax form 8962 when filing their federal tax return. It is important that they file their federal taxes correctly in order to be eligible for tax credits in future years.

  • Learn more about tax form 1095-A.
  • Learn more about tax forms 1095 A, B, C.
  • IRS Guide to Tax Filing

Special Enrollment Resources

Now that open enrollment has closed, customers who want to enroll must qualify for a special enrollment period. The resources below provide more information about special enrollment periods.

  • Webpage
  • Video
  • Factsheet

Washington Apple Health enrollment is year-around. These customers do not need a special enrollment period to apply.

Federal Transition of the Affordable Care Act

Washington Healthplanfinderwill continue offering coverage to Washingtonians while discussions continue at the federal level. It is important to know that any coverage purchased for 2017 will be good for the rest of the year as long as customers pay their monthly premium on time each month.

We will keep you updated about any changes that may affect enrollment in the future. Stay up to date bysubscribing to email updates,liking us on Facebook, orfollowing us on Twitter.

Kaiser Permanente Acquires Group Health Cooperative

Kaiser Permanente's acquisition of Group Health Cooperative became final February 1, and with this change, Group Health has become part of the largest integrated health system in the nation.

Beginning March 6, 2017, Group Health members will be issued Kaiser Permanente cards.

Beginning March 6, 2017 the Kaiser Permanente name, brand, and logo will appear in medical centers, on employee apparel, on member identification cards, on public websites, and more!

Expect to see updated health plan logos in Washington Healthplanfinder March 10, 2017.

For more information about today's announcement, view the press releaseand acquisition FAQs on the Group Health/Kaiser Permanente acquisition page.

Having Payment Issues with Carriers?

When a customer enrolls in a QHP, we send the carrier an electronic enrollment file either the same day or the following day (depending on time of day the enrollment occurred). If you or your client contacts a carrier after enrollment to make a payment and the representative cannot see that your client is enrolled in coverage, email us . We will send you a copy of the electronic record with enrollment information so you can provide it to the carrier. In some cases, you may need to ask to speak to a supervisor or someone who is more familiar with the electronic enrollment files, as the customer service representative may not have access to these files.

Be proactive and call the carrier if you suspect any payment or invoice issues to avoid cancellation of coverage.Learn more about carrier payment options.

Training & Webinars

All training and webinars are available on the password-protected Support Network pages on .

Lunchtime Help Sessions

These help sessions provide an opportunity to share issues you are experiencing, ask questions, and get help related to Washington Healthplanfinder or HBE programs and policies. We will not be answering application-specific questions.

Tuesday, March 21stfrom 12:15 to 12:45 is the next scheduled lunchtime support webinar. You can register at the following link:

Notes from previous help sessions can be found on theTraining and Webinars page.