Add a policy to a member

Every policy on a member belongs to one product line: Health coverage, Medicare, Life, or Supplemental. Add policy asks for the line first, then one more question for Health coverage and Medicare, then opens the policy form.

Add a policy

Open Add policy

Open the member, go to the Policies tab, and click Add policy. The Add button on a product line group (Health Coverage, Medicare) skips straight to that line's question.

Pick the line

Health coverage, Medicare, Life, or Supplemental. Life and Supplemental open the form right away.

Answer the second question

Health coverage asks Marketplace or Private. Medicare asks Medicare Advantage, Medicare Supplement, or Part D, and fills the Plan type on the form with your pick. You can still change it on the form.

Marketplace or private health coverage

Marketplace is an ACA plan bought through Healthcare.gov or a state exchange. The form offers Find a plan on live Marketplace data and has the APTC and FFM application fields.

Private is a plan bought straight from the carrier, off the Marketplace. You enter it by hand from the carrier application. There is no Find a plan, no subsidy field, and no Marketplace application section. The premium you enter is what the member pays.

When Add policy asks you to confirm

Some lines usually do not fit the member. Add policy does not block them. It shows a short note on the card and asks you to confirm before the form opens:

Medicare for a member under 65. This usually means Social Security disability or ESRD.
Medicare when the member already has Health coverage on file. Medicare usually replaces it.
Health coverage when the member already has Medicare on file. Someone enrolled in Medicare does not get a premium tax credit.
Marketplace Health coverage for a member 65 or older. Most members that age qualify for Medicare, which ends premium tax credit eligibility.

What each policy card shows

Health coverage: effective date, monthly premium, subsidy, deductible, OOP max, primary care, metal tier, and plan ID. Back office also sees the effectuation date.
Life: face amount, premium with its mode (for example $62.40 · Monthly), first draft, and effective date. Back office also sees the underwriting status. A Life card never shows a deductible, OOP max, subsidy, or metal tier.
Medicare and Supplemental: effective date and monthly premium, plus deductible, OOP max, or primary care only when they are on the policy.

Life only members

A member whose policies are all Life does not show the insurance card panel on the Documents tab (a card already uploaded stays visible), and shows no renewal date on the Members list. Renewals Due on the Members list does not count them.