On October 17, 2024, the Centers for Medicare & Medicaid Services (CMS) announced new security measures for marketplace submissions through a Classic Direct Enrollment (DE) or Enhanced Direct Enrollment (EDE) platform, such as HealthSherpa.
Agents and brokers are now required to provide verifiable Social Security numbers for all applicants (excluding newborns) when using a DE or EDE platform.
CMS implemented this new requirement to enhance consumer protections and to reduce the need for applicants to provide additional information after submitting their application to maintain their coverage or financial assistance.
Enhanced Direct Enrollment in the Marketplace
EDE platforms allow individuals to compare health plans available on the exchange, enroll in coverage, and receive support from an agent if they wish. With an emphasis on making coverage affordable and accessible, EDE and DE accounted for 57 percent of enrollments in 2023. DE platforms have more limited capabilities, but the enhanced direct enrollment platforms can be a great tool for agents to use in their businesses. EDE platforms are allowed to offer services to see subsidy eligibility, enroll in a plan, and continue to offer customer service to clients who enroll using their services. Their application is user-friendly and may take less time to submit than others.
Agents can utilize EDE to monitor client accounts and make changes if needed. These platforms help bridge the gap between consumers and the marketplace and make it easier for individuals to connect with an agent for assistance. HealthSherpa, Ritter’s preferred EDE platform, can be a great way for agents to acquire new Under-65 leads. One of the advantages of utilizing an EDE tool is the ability to oversee a client’s application if they need assistance. Clients can also access a helpful customer support line.
Addressing Security Concerns in the Marketplace
Since increasing reports of unauthorized activity in the marketplace earlier this year, CMS has been working to find solutions to address security concerns. Requiring a verifiable Social Security number is another step to mitigate the ability for agents to act on their client’s behalf in DE and EDE platforms.
Previously, if an individual failed to submit an SSN at time of application submission, they were asked to provide one after submission to maintain coverage or financial assistance.
Until system changes are implemented in late December 2024, consumers who don’t have a Social Security number can apply for coverage through the marketplace by applying on HealthCare.gov, calling the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325), or using a DE or EDE platform that has a dedicated consumer pathway.
It’s evident from these changes that CMS prioritizes consumer safety and protection. Advancements and new requirements are the client-focused safeguards to increase access and peace of mind across the marketplace.
We’re here to support you through recent compliance changes and enhancements. Become a Ritter agent if you want a team of knowledgeable and helpful staff on your side to help you with these changes!
Not affiliated with or endorsed by Medicare or any government agency.
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