Healthcare.gov and carriers communicate through a 834 form. Think of this as a standard form that Healthcare.gov fills out and sends to the carrier. When HealthSherpa submits an enrollment to Healthcare.gov, we always attach your agent NPN to the application, and Healthcare.gov includes it on the 834 form. Other information (e.g. your Marketplace login, or your carrier writing number) is not included on the 834.
If the application is in your HealthSherpa dashboard, we put your NPN on the application with Healthcare.gov. However, there are a few common issues that can cause errors with 834s - most of these happen after HealthSherpa has transmitted the application to Healthcare.gov:
- Healthcare.gov sometimes fails to transmit 834s correctly to the carriers. They then send a reconciliation file to the carriers, and sometimes carriers discover old enrollments in that reconciliation file that they never received an 834 for. NPNs (and entire enrollments) are sometimes lost this way. Unfortunately, HealthSherpa has no control over the communication between Healthcare.gov and the carrier and can not provide a resolution. To resolve this issue, you can re-submit applications through HealthSherpa, and you will not be charged again for the same person or family.
- Carriers sometimes incorrectly process 834s once they receive them from Healthcare.gov. This can result in agent attribution and/or enrollment errors, as well.
After you speak to the insurance carrier you can follow these steps to have the 834 form amended:
- Contact CMS' Service Desk at 855-267-1515.
- Indicate that you are a broker by selecting option 1, then select option 4 to be connected to a representative.
- The representative will need to gather some information about you, name, birthdate etc.
- Explain to them, you filled out an application for your client on the marketplace with your NPN attached, then you contacted the carrier in regards to that client and the carrier told you that you were not the agent of record.
- Let them know you had an agent advocate call on your behalf to find out what the process is to get the AOR transmitted again to the carrier and was told to have you call in and escalate a ticket once they confirmed that you have a valid NPN.