Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Premium Payment and Issuer Invoices
Program Area: Enrollment and Eligibility (ENR)
Question: If a consumer chooses a zero premium QHP by virtue of applying Advanced Premium Tax Credit (APTC) to 100% of the premium, will the Issuer receive payment from CMS if the issuer doesn't send an effectuation confirmation?
Answer: Qualified health plan (QHP) issuers must send an effectuation transaction to CMS to effectuate the enrollment and receive payment regardless of the premium owed by the enrollee.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 09, 2014
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