MHBE-Overview-of-the-Producer-Authorization-Process - Maryland ...

Individual Marketplace: Enrollment Flow
Application
Eligibility
Determination
Tax Credit
Eligibility
Plan
Shopping
Initial
Payment
Collection
Confirmed
Coverage
Notify
Carriers
Consumer completes
online application for
insurance coverage.
Streamlined
application to allow
for a “no wrong door”
approach.
If not eligible for
Medicaid,
Consumer is
evaluated and
notified of
eligibility for tax
credits.
Consumer is able to
select from available
plans based on
personal
preferences.
Consumer is able
to make the initial
premium payment
directly through
Maryland Health
Connection.
Maryland Health
Connection will
display a message
to the consumer
for coverage start
date.
Maryland Health
Connection will
send a file to
carrier (s) to
notify them of
enrollment
information and
of premiums
collected
Individual Exchange Administration
• Initial Premium billing
• Carrier payment
• On-going eligibility / enrollment management
• Enrollment and funds flow reconciliation
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