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hello we are here today to cover the benavest aca sales process flow for agents and brokers we're going to cover the process of aca sales from a to z i'm regina and i'm here with benavest so let's go ahead and get started before you start selling before anything you want to be sure that you complete your cms certification that will be done on portal.cms.gov if you have not already certified now is definitely the time to get that completed you will also want to do your certification for help on demand help on demand is where clients go to the marketplace and they request assistance from agents the marketplace then sends out that client data to agents to help the clients so those are free leads coming in from the marketplace once those leads come into your help on demand you will be notified you want to set up your notifications via text message so you get that text you log in right away to your help on demand platform and you accept that referral call that client right away no matter what time that lead comes in because that client is actively shopping for insurance and they want to sign up at that time you want to make sure you complete all of your onboarding forms with benavest all of your contracts that are sent your way for the different aca carriers we do need your onboarding forms so we can go ahead and pay you commissions when they do come in the first commission runs for the january plans usually comes end of february sometimes beginning of march but we'll set those expectations for you when we have more information from the carriers but as soon as the statements come to benefest we process those statements we have them ready and as soon as the deposits come in we send everything out to you but we're going to go over more trainings with commissions when it comes closer to after the open enrollment finishes and then of course we'll let you know when those first runs will be coming when we have the data from the carriers so you want to make sure you're appointed with all the carriers after you do your contracting so make sure you get those welcome emails from the carriers that say you are appointed you could also check your appointment status with the carriers or on the state insurance website when you log in there you can see your appointments and once you are appointed with the carriers you do want to register for the broker portal inside the broker portal for you for each carrier you'll be able to see your client data you'll be able to help your clients make payments directly within the portals for oscar example you'll be able to get different details about your contract your appointment and use a lot of different tools that are there as well and then you want to make sure that you get all of your marketing options in place with benevest and what we have to offer your landing pages you want to have access to the member portal with benivest that way you could get more documents and tools that are going to be useful for you so these are all the aca carriers that we have available so some are not in some states some are in multiple states and not others so wherever you are licensed you're going to want to be sure that you're appointed with all carriers in that specific state because you never know maybe you sign up your neighbor for one carrier but then they recommend their cousin that lives in the northern part of the state away from where you're at so you don't want to get all of local carriers you want to get all of the carriers that are in your state and guess what you're not paying for the appointments so why not add them just need to do the contracting once you're contracted that's it you're done contracting you have that one certification for aca and that's it so now let's go over the baseline aca sales script for efficiency being efficient during the open enrollment is going to be one of the best tools that you have in your tool belt so we have created an inbound and outbound script for our in-house agents and we're going to be giving that out to you as well as one of our benevest agents so this script is an essential lifeline that helps start your sales process it is a vital tool in saving time remember the open enrollment is usually from november 1st to december 15th but this year it will be extended throughout january 15th but you want to make the most out of that time it's not a full year round thing that you're going to be doing enrolling so many clients you only have that small window of time so you need to make it most efficient i'm going to cover a little bit of the script but of course this will be sent out to you so you want to read it through in its entirety so we first cover agent disclaimer info and reference to servicing leads servicing your clients and whatnot number one you want to make sure that you are always speaking with a smile on your face no matter what um and that you're always providing the best service to your clients that way they do send your referrals over but make sure you read through this for inbound if you are answering any inbound calls some agents once they reach status then we do put them to answer live calls coming in so what to do in that case for answering inbound calls you always want to make sure at the end of speaking with the client that you have their permission to submit their application electronically that's very important no matter where the client's coming from and then of course we have outbound phone scripts as well so if you're calling out to your clients this script right here we have is to use before the open enrollment starts um you're letting them know we're getting ready for the new healthcare open enrollment period what's going on with covid we want to reach out to them making sure that they have their information in place you could quickly enroll them into their plan for 2022 so again you want to read through this as well read through it a few different times that way you can get it kind of memorized in your head and then you could kind of sum it up when you're speaking to the client remember not every call is black and white some calls you may gather different information with your probing with the client so you want to kind of go with the flow making sure you're spending the right amount of time with the client not taking hours for one call because that way you'll get pushed behind now let's cover qualifying a client so these are going to be the main questions that you are going to be asking your clients so when you're on the phone with the client you're going to ask who needs the coverage in your family what is the household size so remember their household size is not the number of people living inside of their house the household size is who is included on their taxes so they have their taxes in front of them count how many people are on the taxes themselves their wife their kids how many people one two three four five that's what you need to know what is the projected income for 2022 for the household so based on the number of people on their taxes what is their projected income so you're going to want to have your income chart in front of you and i'm going to go over that shortly are you married if you're married you file taxes together they have to file together to get that tax credit that tax subsidy if they're not if they're married and they're not falling together they're already getting credits for some things so the government's not going to provide them more credits for their insurance in the household is everyone employed are you self-employed do you have a 1099 do you get a w-2 you may need to help them with their calculations a little bit and you could also guide them to their accountant to see what their income was in 2021 to help them with their projection of income for 2022 remember the insurance is for 2022. that means you need the projection of income the number of household members for 2022. okay if self-employed what is their adjusted gross income their income after their deductions does employer offer affordable coverage at 9.83 percent of the household annual income or lower so you may need to assist with this and the calculations as well are you a citizen were you born here in the united states um yes i was born here in the united states or they'll say no then you just ask what their status of citizen citizenship is and you may need to get their documentation immigration documents that way you could upload them to the application for them but we're going to cover documentation later on if again if they're married filing separate they may not get a subsidy if they're not in the income brackets they may not get the subsidy medicare part b only they need to apply to check if they're going to get that subsidy or not um if the spouse is insured through an employer but the other is not they may not get the subsidy so make sure you're asking these probing questions does your employer offer coverage are you married what's your projected income what's your household sites make sure to ask these questions that way you're not spending so long on the phone with the client step number two other qualification tips so in reference to employer coverage affordability so for 2022 the maximum monthly premium contribution that meets federal poverty guidelines safe harbor will be 9.83 of the prior year's federal poverty level so you take that amount for a single person twelve thousand eight eighty and you're going to divide it by twelve so they need not pay more than one thousand seventy three dollars a month for employer coverage if they are then it's not affordable okay some here are some helpful useful links that we use a lot i recommend you to save them in your bookmarks bar on your computer so their job does offer insurance and you need a little bit more guidance you're going to want to go to healthcare.gov okay this is going to assist you with that those different questions that them that the client may have and of course these are all clickable links for you their immigration status so again these are all clickable documentation type read through all these different articles to help you out read them before the open enrollment starts that way you kind of have it in your mind full-time student does anyone smoke so let me go a little bit into healthcare.gov so healthcare.gov is the government website for insurance for obamacare aca insurance one of the most useful tips here that we see that our agents utilize is the search feature in healthcare.gov so you could type anything in here if you may not know and then you're going to find articles on that so let's just type subsidy search and then all these different articles are going to come up and you could read through them so how to save on monthly premiums income chart income levels and then there's different information down here so here you could go ahead and you could plug in the information for the client play around with it you're not going to break anything of the system another important tool that we use is c topics so under c topics these are different um most utilized articles so again you want to read through them to get more familiar with different coverage and things like that if you are ever with the client and you are unsure please send us an email to office benivest.com and in the subject line put help aca client urgent so we know that your email coming in is urgent because you are sitting with the client in front of you so we're going to go ahead and answer your email prior to answering other emails that are coming in maybe for contracting or things like that you're with the client in front of you so you need help with the client so please feel free to email us questions that you may have okay remember on our team we only have a few licensed insurance agents so the regular staff they mean they're not able to answer the questions that you have in reference to cms or to insurance plans and products because they're not licensed so you definitely want to make sure you're learning all the information that you need to as a licensed insurance agent prior to the open enrollment coming okay utilize the carriers utilize healthcare.gov find out all the information that you need to go to the different trainings for the carriers to learn about all their products and then make sure you utilize those healthcare.gov articles as well step number three go over who is included in the household so remember they have their taxes in front of you how many people are on the taxes so verify the household information with the client again are they single or are they married if they're married they must fall together for 2022 to receive the tax credit doesn't matter what they did in 2021 what matters is what they're going to do in the next year because the insurance will be for the next year okay how do they file the taxes do they claim any dependents do any dependents need coverage so all members on the taxes need to be inputted into the application it does not mean that you're inputting everyone into the application and they are going to get insurance no you are just inputting their information into the application to match their taxes maybe only one person needs insurance fine but you need to make sure that you're inputting all of the people that are inside of their household household meaning their taxes okay and here's an article again that leads to healthcare.gov that will help you with knowing what we recommend is we print this page out and you have it in front of you in your computer this is going to be utilized a lot save it in your bookmarks bar as well all these links on this training are clickable okay so make sure you read those different articles step number four go over what is included in the household income for the family okay so are do you get a w-2 or are you self-employed so remember the self-employed is after their deductions sometimes you might have a husband with a w-2 and a wife with a 1099. so you need to get the correct income figure maybe the 1099 has a loss and it doesn't have a profit so that's where you're going to have to kind of probe and get that information from the client so use what's included as the income chart so i'm going to go over the income chart shortly and also there's another deep dive training that i will go into the income chart with you does the client have any deductions how to estimate the income what's included as income and the income chart so again these are all clickable and leads different articles that you're going to want to read sometimes you get clients that have social security ssi so you need to know if it's included or if it's not right here it says do not include so if i had someone that had social security income and i'm not sure i could type it in the search bar here and it will let me know or let's say child support child support is never included because it is not on the taxes so i typed it in and then it's going to leave me here quickly you could do a control f feature control find child support okay and then it brought me here and you want to read the different information child support payments or non-taxable property settlements um ordered or okay let's talk about alimony incomes you shouldn't report do not include child support okay so kind of tells you the information here so you find the article and then you can control find to find out information there if it's not included in the taxes it will not be included as income so now the income chart for the open enrollment so it goes by the 2021 federal poverty guidelines chart because this is what the government has made so what i like to tell the clients um sometimes it's easier if they're sitting with me but what i tell them is this is an income that's needed to qualify for a tax credit so anyone can sign up for insurance but not everyone will qualify for the tax subsidy the tax credit portion so if you are underneath and this is for florida if you are underneath this 100 and you're over here in the chart then you're not going to qualify because you don't have that income the subsidy is based on income so you need income in order to qualify so if you're a single person you will need twelve thousand eight hundred eighty dollars or more to qualify for the tax credit so let's say thirteen thousand help you remember okay the more money that you're going to make the less money the government's gonna give you to help towards your insurance so anyone that falls below will not qualify for the tax credit anyone at the mark or more the more you make the government's gonna give you less towards your insurance okay so that's an easy way to explain it in florida they're not going to get insurance if they're below the income level in states that expanded medicaid people below the 100 level would automatically qualify for medicaid but medicaid expansion is up to the governor of the state and florida did not expand medicaid okay so you could direct those clients to their local hospital things like that that might have their own internal insurance for people with low or lower income okay and the more they're gonna make the less money they need help with so remember the obamacare tax credit the subsidy is income based so you could kind of use analogies so if someone files their taxes and they have college students they could get a credit for college but i'm not a college student so i'm not going to qualify for that tax credit so if someone doesn't have income then they're not going to qualify for the tax credit for the insurance the tax subsidy to pay for their health insurance okay if someone has a house they get a tax credit on their insurance on their taxes if someone doesn't have a house they're not going to qualify for that tax credit so you could kind of explain it that way because sometimes you're going to get clients that maybe get upset so you're going to want to have that little bit of information to kind of explain it to them and maybe they'll be like oh okay light bulb moment so they're kind of more better at understanding what's included as income so we went over that a little bit and what's not included this is another chart you're going to want to print this out as well okay the next step step five quote and go over how much of the tax credit they qualify for so when you're quoting the quant when you're quote sorry when you're quoting the client you're gonna want to go to healthcare.gov c dash plans this is my go to spot for quoting any client you're going to need their zip code their ages and the combined household income so let me go ahead and put it here so i can show you right now the 20 20 20 20 22 health plans are not available yet so if it's just a single person or is it you and other people so remember this is who's in the household who is on their taxes and it explains it right here too your household includes you your spouse if married and everyone you'll claim as dependent on your tax return include them all even if they don't need coverage so who is in the household in this case i'll just say you and other people are you married i'll keep it simple now will you claim any dependents since i said you and other people i'll say yes one dependent your age and then make sure you're reading through these when you're doing your quotes i know this like in my sleep so i don't need to read it now and to help expedite the training i'm not going to but you can read it while you're doing your training okay up i forgot to add the dependent because i didn't put the gender okay two people and then what's the income for the year so two people their income needs to be about 17 500 or more to qualify for the tax credit if someone's with the w-2 very easy you're going to put that amount of the w-2 into the amount here if someone is at 1099 then it's a little bit more probing and maybe guiding to help them find out their income for 2022 make sure you always have a calculator in front of you okay i'll just say 20 000 who's um anyone getting unemployment say none of these people okay and then now it's going to tell you the subsidy which i didn't put though right i'm out i must mess something let's see here i put two thousand this is missing a zero so twenty thousand now they're going to get the tax credit of about 405 a month always just estimate this is not the finals always this is an estimate okay so you're going to quote the client and explain that all members family members must be included on the application with all relative information but you're only applying for coverage for those who need the coverage so remember everyone in the household is on the application and then you're going to notate yes to the people that need the insurance okay and then you're going to explain what the tax credit is tell the client that in january 2022 if they had obamacare for this past 2021 then they're going to get a 1095 tax form they're going to need that to give that form to their accountant so next year in january the following year january 2023 they're going to get a tax form for their insurance that they had in 2022 so now i explained to the cl to the client now your tax credit is about 400 a month that the government's going to pay towards your insurance so with that being said let's go over the plans that you qualify for the lowest cost plan right here is going to be a zero dollar plan now with this plan the benefits are pretty rich but there's not as rich as a silver plan it goes bronze and silver is what we're going to want to look at because you have a tax credit so with this zero dollar plan then you could go over the information here again these are 2021 plans so i'm not going to go into it but i'm just going to give you an idea zero dollars a month the government's going to pay for your full plan the primary doctor is free the specialist is five dollars your deductible is zero and your out of pocket maximum is fifteen hundred dollars that's the maximum you're going to pay out of your pocket for medical procedures doctor visits prescriptions things like that the next plan that we're going to cover and then you could keep going into the plans i'm not going to go over these because the out-of-pocket max is more than the other one so it doesn't make sense for me to go into those i'm not going to go over every single plan with the client i'm going to go over the ones that make sense the first plan the primary was free right so why would i go over these i will not go over these okay we're still at the bronze so let's go down to silver they go in metal order and based on pricing so we're still at bronze you see how many plans are i'm not gonna go over the plans with the client i'm gonna go over what makes sense so the first silver plan the silver plan has more benefits for you this is going to cost you two dollars and 80 cents a month this plan the primary doctor is free and the specialist is five dollars the deductible zero and the out of pocket max is 1500 and i'm sorry what i forgot to do agent is i forgot to compare it with the other one so we could kind of go more into details with the client this one makes no sense 35 copay after deductible i would never show that one because this one is free the doctor's free i'm gonna do what's best for the client okay we skip those my blue these are no charge after deductible 50 that doesn't make any sense here's a no charge okay no charge here's another no charge with a different carrier okay so let's compare these and then let me go all the way back to that first page to get that first free bo free bronze plan to show you the compare feature compare three plans put them side by side to make it a little bit easier for you okay and here we go so we're going to compare the three plans so two plans are with bright health and one is with oscar and then you can see the pricing here cost some medical care it will show you specialist 5.10 so you could go ahead and break it down with the client and then you also want to let the client know hey do you want to do you have a doctor that you currently visit and if the client says that yes then you're going to want to let the client know to call into the doctor's office and find out which aca obamacare plans they accept