Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Enrollment and Initial
Program Area: Enrollment and Eligibility (ENR)
Question: Can an individual be prevented from making changes to their initial selection until the first Qualified Health Plan (QHP) issuer has collected payment and sent the confirmation back to the Federally-facilitated Marketplace (FFM)?
Answer: No. Changes cannot be held until the issuer has collected payment. In a scenario where a qualified individual changes his/her original QHP selection during a valid enrollment period, the Federally-facilitated Marketplace (FFM) will provide the QI the payment redirect URL for the new QHP and assign a new Payment Transaction ID. The FFM will send an ASC X12 cancellation transaction to the "losing" QHP, and will create a new initial ASC X12 834 enrollment transaction for the new QHP selected.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 09, 2013
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