Authorized Functions. WBE may create, collect, disclose, access, maintain, store, and use PII for: 1. Assisting with applications for QHP eligibility; 2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons; 3. Assisting with applications for the receipt of APTCs or CSRs, and selecting an APTC amount; 4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable; 5. Assisting with the application for and determination of certificates of exemption; 6. Assisting with filing appeals of eligibility determinations in connection with the FFE; 7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR and APTC information to the FFE; 8. Facilitating payment of the initial premium amount to appropriate QHP; 9. Facilitating an Enrollee’s ability to disenroll from a QHP; 10. Educating Consumers, Applicants, or Enrollees on insurance affordability programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP); 11. Assisting an Enrollee’s ability to report changes in eligibility status to the FFE throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent); 12. Correcting errors in the application for QHP enrollment; 13. Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal; 14. Providing appropriate information, materials, and programs to Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them about the use and management of their health information, and services and options offered through the selected QHP or among the available QHP options; 15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE in connection with the FFE, WBE or QHPs; 16. Providing assistance in communicating with QHP Issuers; 17. Carrying out the legal responsibilities related to the efficient functions of QHP Issuers in the FFE, as permitted or required by WBE’s contractual relationships with QHP Issuers; and 18. Other functions substantially similar to those enumerated above and such other functions that may be approved by CMS in writing from time to time.
Appears in 4 contracts
Samples: Web Broker Agreement, Web Broker Agreement (eHealth, Inc.), Web Broker Agreement
Authorized Functions. WBE EDE Entity may create, collect, disclose, access, maintain, store, and use PII forfor the following, if applicable:
1. Assisting with completing applications for QHP eligibility;
2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. Assisting with completing applications for the receipt of APTCs APTC or CSRs, CSRs and with selecting an APTC amount;
4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable;
5. Assisting with the application for and determination of certificates of exemption;; 2 Unless specifically indicated otherwise, references to the ISA refer to the current, legally enforceable version of the agreement. The ISA is available on CMS zONE at the following link: xxxxx://xxxx.xxx.xxx/document/privacy-and- security-audit.
6. Assisting with filing appeals of eligibility determinations in connection with the FFEFFEs and SBE-FPs;
7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR and APTC information to the FFEFFEs and SBE-FPs;
8. Facilitating payment of the initial premium amount to the appropriate QHPQHP Issuer;
9. Facilitating an Enrollee’s ability to disenroll from a QHP;
10. Educating Consumers, Applicants, Qualified Individuals or Enrollees Enrollees—or these individuals’ legal representatives or Authorized Representatives— on insurance affordability programsInsurance Affordability Programs and, and if applicable, informing such individuals of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP);
11. Assisting an Enrollee’s ability to report Enrollee in reporting changes in eligibility status to the FFE FFEs and SBE-FPs throughout the coverage year, including changes that may impact affect eligibility (e.g., adding a dependent);
12. Correcting errors in the application for QHP enrollment;
13. Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. Providing appropriate information, materials, and programs to Consumers, Applicants, Qualified Individuals, and Enrollees, —or these individuals’ legal representatives or Authorized Representatives—to inform and educate them about the use and management of their health information, and as well as medical services and benefit options offered through the selected QHP or among the available QHP options;
15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE in connection with the FFE, WBE or QHPs;
16. Providing assistance in communicating with QHP Issuers;
17. Carrying out the legal responsibilities related to the efficient functions of QHP Issuers in the FFE, as permitted or required by WBE’s contractual relationships with QHP Issuers; and
18. Other functions substantially similar to those enumerated above and such other functions that may be approved by CMS in writing from time to time.
Appears in 2 contracts
Samples: Enhanced Direct Enrollment Agreement, Enhanced Direct Enrollment Agreement
Authorized Functions. WBE Agent may create, collect, disclose, access, maintain, store, and use PII for:only to perform the following authorized functions (“Authorized Functions”):
1. (a) Assisting with applications for QHP eligibility;
2. (b) Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. (c) Assisting with applications for the receipt of APTCs APTC or CSRsCSR, and selecting an APTC amount;
4. (d) Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable; exemption; YHI;
5. (e) Assisting with the application for and determination of certificates of exemption;of
6. (f) Assisting with filing appeals of eligibility determinations in connection with the FFE;with
7. (g) Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or or CSR and APTC information to the FFEYHI;
8. (h) Facilitating payment of the initial premium amount amounts to the appropriate QHP;
9. (i) Facilitating an Enrollee’s ability to disenroll from a QHP;
10. (j) Educating Consumers, Applicants, or Enrollees on insurance affordability programsInsurance Affordability Programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP);
11. (k) Assisting an Enrollee’s ability Enrollee to report changes in eligibility status to the FFE YHI throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent);
12. (l) Correcting errors in the application for QHP enrollment;
13. (m) Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. (n) Providing appropriate information, materials, and programs to inform and educate Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them Enrollees about the use and management of their health information, information and services and options offered through the selected QHP or and among the all available QHP options;
15. (o) Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE Agent in connection with the FFE, WBE YHI or QHPs;
16. (p) Providing assistance in communicating with QHP Issuers;
17. (q) Carrying out the Agent’s legal responsibilities related to the efficient QHP Issuer functions of QHP Issuers in the FFEYHI’s marketplace, as permitted or required by WBEAgent’s contractual relationships with QHP Issuers; and
18. (r) Other functions substantially similar to those enumerated above and such any other functions that may be approved by CMS YHI approves in writing from time to time.
Appears in 2 contracts
Samples: Insurance Producer Agreement, Insurance Producer Agreement
Authorized Functions. WBE ABE may create, collect, disclose, access, maintain, store, and use PII only for:
1. Assisting with applications for QHP eligibility;
2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. Assisting with applications for the receipt of APTCs APTC or CSRs, and selecting an APTC amount;
4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR CSRs determination, if applicable;
5. Assisting with the application for and determination of certificates of exemption;
6. Assisting with filing appeals of eligibility determinations in connection with the FFEFFEs or SBE-FPs;
7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR CSRs and APTC information to the FFEFFEs or SBE-FPs;
8. Facilitating payment of the initial premium amount to for the appropriate QHP;
9. Facilitating an Enrollee’s ability to disenroll from a QHP;
10. Educating Consumers, Applicants, Qualified Individuals, or Enrollees on insurance affordability programsInsurance Affordability Programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP);
11. Assisting an Enrollee’s ability to report changes in eligibility status to the an FFE or SBE-FP throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent);
12. Correcting errors in the application for QHP enrollment;
13. Informing or reminding Enrollees when QHP coverage should be renewed, renewed or when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. Providing appropriate information, materials, and programs to inform and educate Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them Enrollees about the use and management of their health information, information and services and options offered through the selected QHP or and among the available QHP options;
15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE ABE in connection with the FFEFFEs, WBE SBE-FPs, or QHPs;
16. Providing assistance in communicating with QHP Issuers;
17. Carrying out the ABE’s legal responsibilities related to the efficient QHP Issuer functions of QHP Issuers in the FFEFFEs or SBE-FPs, as permitted or required by WBEABE’s contractual relationships with QHP Issuers; and
18. Other functions substantially similar to those enumerated above and such other functions that may be approved by CMS in writing from time to time. An ABE may not under any circumstances create a XxxxxxXxxx.Xxx account for a consumer, log into a consumer’s XxxxxxXxxx.Xxx account, log into XxxxxxXxxx.Xxx as a consumer, or create, collect, disclose, access, maintain, store, or use PII for such purposes.
Appears in 2 contracts
Samples: Agent or Broker Agreement, Agent or Broker Agreement
Authorized Functions. WBE ABE may create, collect, disclose, access, maintain, store, and use PII for:
1. Assisting with applications for QHP eligibility;
2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. Assisting with applications for the receipt of APTCs or CSRs, and selecting an APTC amount;
4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable;
5. Assisting with the application for and determination of certificates of exemption;
6. Assisting with filing appeals of eligibility determinations in connection with the FFEFFEs or SBE-FPs;
7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR and APTC information to the FFEFFEs or SBE-FPs;
8. Facilitating payment of the initial premium amount to appropriate QHP;
9. Facilitating an Enrollee’s ability to disenroll from a QHP;; and
10. Educating Consumers, Applicants, or Enrollees on insurance affordability programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP);.
11. Assisting an Enrollee’s ability to report changes in eligibility status to the FFE or SBE-FP throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent);
12. Correcting errors in the application for QHP enrollment;
13. Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of coverage QHP coverage options at renewal;
14. Providing appropriate information, materials, and programs to inform and educate Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them Enrollees about the use and management of their health information, information and services and options offered through the selected QHP or and among the available QHP options;
15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE ABE in connection with the FFEFFEs, WBE SBE-FPs or QHPs;
16. Providing assistance in communicating with QHP Issuers;
17. Carrying out the XXX’s legal responsibilities related to the efficient QHP Issuer functions of QHP Issuers in the FFEFFEs or SBE-FPs, as permitted or required by WBEXXX’s contractual relationships with QHP Issuers; and
18. Other functions substantially similar to those enumerated above and such other functions that shall may be approved by CMS in writing from time to time.
Appears in 1 contract
Samples: Agreement Between Agent or Broker and the Centers for Medicare & Medicaid Services
Authorized Functions. WBE Agent may create, collect, disclose, disclose access, maintain, store, and use PII for:only to perform the following authorized functions (“Authorized Functions”):
1. (a) Assisting with applications for QHP eligibility;
2. (b) Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. (c) Assisting with applications for the receipt of APTCs or CSRs, and selecting an APTC amount;
4. (d) Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable;
5. (e) Assisting with the application for and determination of certificates of exemption; YHI;
6. (f) Assisting with filing appeals of eligibility determinations in connection with the FFE;with
7. (g) Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or or CSR and APTC information to the FFEYHI;
8. (h) Facilitating payment of the initial premium amount amounts to the appropriate QHP;
9. (i) Facilitating an Enrollee’s ability to disenroll from a QHP;
10. (j) Educating Consumers, Applicants, or Enrollees on insurance affordability programsInsurance Affordability Programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP);
11. (k) Assisting an Enrollee’s ability Enrollee to report changes in eligibility status to the FFE YHI throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent);
12. (l) Correcting errors in the application for QHP enrollment;
13. (m) Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. (n) Providing appropriate information, materials, and programs to inform and educate Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them Enrollees about the use and management of their health information, information and services and options offered through the selected QHP or and among the all available QHP options;
15. (o) Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE Agent in connection with the FFE, WBE YHI or QHPs;
16. (p) Providing assistance in communicating with QHP Issuers;
17. (q) Carrying out the Agent’s legal responsibilities related to the efficient QHP Issuer functions of QHP Issuers in the FFEYHI’s marketplace, as permitted or required by WBEAgent’s contractual relationships with QHP Issuers; and
18. (r) Other functions substantially similar to those enumerated above and such any other functions that may be approved by CMS YHI approves in writing from time to time.
Appears in 1 contract
Samples: Insurance Producer Agreement
Authorized Functions. WBE ABE may create, collect, disclose, access, maintain, store, and use PII only for:
1. Assisting with applications for QHP eligibility;
2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. Assisting with applications for the receipt of APTCs APTC or CSRs, and selecting an APTC amount;
4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR CSRs determination, if applicable;
5. Assisting with the application for and determination of certificates of exemption;
6. Assisting with filing appeals of eligibility determinations in connection with the FFEFFEs or SBE-FPs;
7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR CSRs and APTC information to the FFEFFEs or SBE-FPs;
8. Facilitating payment of the initial premium amount to for the appropriate QHP;
9. Facilitating an Enrollee’s ability to disenroll from a QHP;
10. Educating Consumers, Applicants, Qualified Individuals, or Enrollees on insurance affordability programsInsurance Affordability Programs, and if applicable, informing such individuals of eligibility for Medicaid or Children’s Health Insurance Program (CHIP);
11. Assisting an Enrollee’s ability to report changes in eligibility status to the an FFE or SBE-FP throughout the coverage year, including changes that may impact eligibility (e.g., adding a dependent);
12. Correcting errors in the application for QHP enrollment;
13. Informing or reminding Enrollees when QHP coverage should be renewed, renewed or when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. Providing appropriate information, materials, and programs to inform and educate Consumers, Applicants, Qualified Individuals, and Enrollees, to inform and educate them Enrollees about the use and management of their health information, information and services and options offered through the selected QHP or and among the available QHP options;
15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE ABE in connection with the FFEFFEs, WBE SBE-FPs, or QHPs;
16. Providing assistance in communicating with QHP Issuers;
17. Carrying out the XXX’s legal responsibilities related to the efficient QHP Issuer functions of QHP Issuers in the FFEFFEs or SBE-FPs, as permitted or required by WBEXXX’s contractual relationships with QHP Issuers; and
18. Other functions substantially similar to those enumerated above and such other functions that may be approved by CMS in writing from time to time. Xx XXX may not under any circumstances create a XxxxxxXxxx.Xxx account for a consumer, log into a consumer’s XxxxxxXxxx.Xxx account, log into XxxxxxXxxx.Xxx as a consumer, or create, collect, disclose, access, maintain, store, or use PII for such purposes.
Appears in 1 contract
Samples: Agent or Broker Agreement
Authorized Functions. WBE EDE Entity may create, collect, disclose, access, maintain, store, and use PII for:
1. Assisting with completing applications for QHP eligibility;
2. Supporting QHP selection and enrollment by assisting with plan selection and plan comparisons;
3. Assisting with completing applications for the receipt of APTCs APTC or CSRs, CSRs and with selecting an APTC amount;
4. Facilitating the collection of standardized attestations acknowledging the receipt of the APTC or CSR determination, if applicable;
5. Assisting with the application for and determination of certificates of exemption;
6. Assisting with filing appeals of eligibility determinations in connection with the FFEFFEs and SBE-FPs;
7. Transmitting information about the Consumer’s, Applicant’s, Qualified Individual’s, or Enrollee’s decisions regarding QHP enrollment and/or CSR and APTC information to the FFEFFEs and SBE-FPs;
8. Facilitating payment of the initial premium amount to the appropriate QHP;
9. Facilitating an Enrollee’s ability to disenroll from a QHP;
10. Educating Consumers, Applicants, Qualified Individuals or Enrollees on insurance affordability programsInsurance Affordability Programs and, and if applicable, informing such individuals of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP);
11. Assisting an Enrollee’s ability to report changes in eligibility status to the FFE FFEs and SBE-FPs throughout the coverage year, including changes that may impact affect eligibility (e.g., adding a dependent);
12. Correcting errors in the application for QHP enrollment;
13. Informing or reminding Enrollees when QHP coverage should be renewed, when Enrollees may no longer be eligible to maintain their current QHP coverage because of age, or to inform Enrollees of QHP coverage options at renewal;
14. Providing appropriate information, materials, and programs to Consumers, Applicants, Qualified Individuals, and Enrollees, Enrollees to inform and educate them about the use and management of their health information, and as well as medical services and benefit options offered through the selected QHP or among the available QHP options;
15. Contacting Consumers, Applicants, Qualified Individuals, and Enrollees to assess their satisfaction or resolve complaints with services provided by WBE in connection with the FFE, WBE or QHPs;
16. Providing assistance in communicating with QHP Issuers;
17. Carrying out the legal responsibilities related to the efficient functions of QHP Issuers in the FFE, as permitted or required by WBE’s contractual relationships with QHP Issuers; and
18. Other functions substantially similar to those enumerated above and such other functions that may be approved by CMS in writing from time to time.
Appears in 1 contract
Samples: Enhanced Direct Enrollment Agreement