Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Transactions and 834
Program Area: Enrollment and Eligibility (ENR)
Question: If the FFM does not want a confirmation 834 on transactions like Change/Reinstate/ Terminate/Cancel and only wants the effectuation on initial enrollment if the initial enrollment was complete and the subscriber added one member, will the Marketplace treat the 'ADD MEMBER' transaction as an initial enrollment for that member and therefore, require an effectuation 834 from the payer?
Answer: Yes, a member add is considered initial enrollment and will require a confirmation transaction.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 21, 2013
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