Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Premium Payment and Premium Payment Re-Direct
Program Area: Enrollment and Eligibility (ENR)
Question: If an individual forgoes using the payment redirect session with the Qualified Health Plan (QHP) before completing the payment process, does the ASC X12 834 enrollment transaction continue from the Federally-facilitated Marketplace (FFM) to the QHP issuer for that individual?
Answer: Yes, if an individual has confirmed a Qualified Health Plan (QHP) selection on the Federally-facilitated Marketplace (FFM) site the FFM will always transmit the individual's choice to the QHP in the daily enrollment transaction regardless of whether the individual did not complete the online payment process via the redirect process,. The issuer can use the enrollment transaction information to generate a premium bill for enrollees who have not yet made their first premium payment.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 09, 2013
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