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Federally Facilitated Marketplace

The Federally Facilitated Marketplace (FFM) MAC Learning Collaborative provides a forum for states that are interfacing with the FFM for eligibility and enrollment functions. Consumers in FFM and State Partnership Marketplace (SPM) states have the option to apply for Insurance Affordability Programs (Medicaid, Children’s Health Insurance Program [CHIP] and Premium Tax Credits) through state Medicaid and CHIP agencies or through the FFM. This requires close coordination between states and the FFM to ensure an effective and streamlined eligibility process. Products developed by the Collaborative include:

Account Transfers

To assist states with identifying practical strategies to manage application volume and facilitate timely enrollment of Medicaid/CHIP eligible individuals:

Consumer Assistance

To assist states with consumer assistance plans for good consumer experiences during open enrollment.

Verification

As states navigate the Affordable Care Act’s requirement for coordinated eligibility and enrollment systems and real-time verifications, the Simplified, Real-Time Verification Issue brief outlines lessons from Louisiana, Oklahoma and Oregon for developing streamlined eligibility and enrollment pathways that achieve administrative efficiencies, improve consumers’ experience, and facilitate timely access to coverage and health care.

Applications and Renewals

Information about the streamlined application used in the FFM and relevant interactions with Medicaid and CHIP.

States’ Eligibility & Enrollment Functionality

The following reviews key findings from the “Year 2 Consults” – a process states and CMS undertook together to assess states’ Medicaid/CHIP eligibility and enrollment policy, operations and systems functionality. The information provides a snapshot of states’ functionality at the end of 2014 and beginning of 2015 and does not take into account states’ approved mitigation plans.