This Open Enrollment Period (OEP), we've launched new reporting features to help you understand the renewal risk associated with each client. This will help you prioritize which of your clients you may wish to actively renew.
In this article we will cover:
Renewals task view
You now have access to a Renewals tab within the Clients page of your HealthSherpa for Agents account. This renewals task view is designed to help you prioritize your renewal book so you can maximize efficiency during OEP.
The renewals task view displays your full client list, and dynamically updates when status changes take place. Here, you will find clients who are at risk of not renewing, losing their subsidy, are experiencing a significant crosswalk change, and even clients who have already renewed.
Columns included in the renewals task view include the following:
Client: This is the primary applicant's name. At this time, the renewals task view does not include enrollments with multiple enrollment groups.
Renewal status: Renewal statuses that display are:
Action needed: This means that your client will either not be passively renewed or will lose their subsidy (if subsidy eligible). Risk statuses such as ‘BAR disabled,’ ‘Tax return access denied,’ and ‘No crosswalk plan’ will trigger an ‘Action needed’ renewal status.
Action recommended: This means your client will either be crosswalked into a new plan or remain on their existing plan. Risk statuses such as ‘Plan change,’ ‘Carrier change,’ and ‘No change’ will trigger an ‘Action recommended’ renewal status.
Actively renewed: The client has actively renewed
Risk factors: These are factors that expand on the renewal status listed for your client. Risk factors include:
BAR disabled: The client opted out of BAR and will not renew passively
Tax return access denied: CMS does not have access to the appropriate IRS documents (tax documents could also be missing or expired) for the client, which will result in a loss of subsidy
No crosswalk plan: The client’s current plan is no longer being offered and a crosswalk plan is not available. The client will not renew passively.
Plan change: the client is being crosswalked to a new plan with their current carrier
Carrier change: the client is being crosswalked to a new plan with a new carrier
No plan change: The client will remain on the same plan with the same carrier, although benefits, network, and formulary may still adjust
Action: Most crucially, this column allows you start an active renewal directly from the Renewals tab. Selecting the “Renew now” button will allow you to shop for plans first; selecting “Start with the application” will allow you to begin with application updates instead (you will land on the privacy page). Learn more about available renewal flows here. Note: Once you begin a renewal application for a client, the ‘renew now’ button will no longer be available. To resume a renewal application that has already begun, go to the client details page.
Frequently asked questions
What is an active renewal?
An active renewal takes place when a consumer updates their Marketplace application during the annual Open Enrollment Period (OEP) and selects a new plan for the upcoming plan year. With consent, agents, brokers, and other authorized representatives may assist consumers with active renewals. Learn more about active renewals here.
What is a passive renewal?
Passive renewals are designed to ensure consumers have an opportunity to maintain uninterrupted coverage, even if they take no action during OEP. Passive renewals are designed to be a “safety net” so that consumers can maintain coverage, but it is always best practice to reach out to your client and actively renew. Learn more about passive renewals here.
What does "Crosswalk" mean?
CMS automatically "crosswalks" consumers to new health plans when:
The consumer's current plan is discontinued for the upcoming plan year and a close plan equivalent exists
OR When a carrier will no longer offer plans where the consumer resides for the upcoming plan year
Consumers who have opted out of BAR will not be crosswalked and therefore will not passively renew.
What is BAR?
BAR stands for Batch Auto Re-enrollment. BAR is a process used by Marketplaces to ensure consumers who are currently enrolled in Qualified Health Plans (QHPs) who do not engage in new plan selection by the end of OEP retain coverage for the upcoming plan year.
BAR is a behind-the-scenes process that CMS begins in October each year and continues through December. Consumers may be included in the BAR process at any point during this time. CMS creates a new FFM application ID and selects a plan for the consumer then sends this information to Carriers to passively renew the consumer.
Consumers may choose to opt out of BAR. Learn more about the BAR process here.
How does CMS prioritize BAR for consumers?
CMS prioritizes BAR for consumers based on enrollment effective dates.
Consumers with effective dates earlier in the year will likely be part of initial BAR waves, whereas consumers with effective dates later in the year may be part of CMS’ BAR processes in later waves.
CMS considers the most recent plan effective date for consumers during these waves.
Additional Resources
Have questions? Contact our Agent Support Team at (888) 684-1373 or agent_support@healthsherpa.com.
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