Frequently Asked Questions

Have a question? Click on a question below to get answers to some of our frequently asked questions.

General

What happens after a member is enrolled?
  • Welltheos will send the member's information back to the marketplace where they will then be contacted by the Health Plan they have chosen for payment and effectuation.
Where can brokers or agencies get more help?
  • 1-800-947-6757 or info@welltheos.com
How should I submit technical issues or suggestions for new features?
  • We are committed to making the enrollment process quick and painless for the broker and agency community. If you are experiencing any issues when using the Welltheos site or would like to offer suggestions on how to better the process, please contact us at info@welltheos.com.
Is there anything that is required prior to the registration of my Welltheos account?
  • Yes, you will need to contract with any affiliated healthcare insurers whose products you would like to sell through Welltheos. You will also need to register with CMS to sell plans on the marketplace.
Will I be able to share a personal broker URL for applicants to visit and enroll?
  • Yes, custom broker URLs are available
  • Once you log in to your Broker account, on the left tab, click the "Account Info" button.
  • Midway down the page, you will see "Profile Name"
  • You can now enter your desired username and use the custom URL to the right
  • This URL can be sent to clients for enrollment that will contain your NPN
How can I unregister from the site if needed?
  • You can email info@welltheos.com with the Subject Line Unregister. We will delete your account from our database at that time.
Do I accept payment from the member after they have enrolled?
  • No, all payments from members will be made through the selected carrier's payment portal. Once a member is effectuated, brokers will receive commissions directly from the Health Plan the member has chosen based upon the commission agreement between the Insurer and the Agent/Broker.
I'm new to Welltheos- how do I get started?
  • If you're a broker, go to https://www.welltheos.com/WBE/Broker. Then click the button marked: "Click Here to Get Started!"
  • Once you enter your National Producer Number (NPN) and click continue, you will then be asked to fill out the rest of your broker information
  • Click the "Register" button
  • You will then get a confirmation email and you should be ready to start enrolling.
I already have a Welltheos account, how do I create an Agency portal?
  • Go to http://www.welltheos.com/WBE/Agency. Then click the button marked: "Click Here to Get Started!"
  • Once you enter your agency information, click the "Register" button
  • You will then receive a confirmation email
  • Under the "Branding" tab, you can upload your agency logo, change your theme color, and send out links for your websites.
How do I associate my Welltheos broker portal to my Welltheos agency portal?
  • Once you log in, please find your way to the Broker Overview tab on the left. Within that tab will be two links.
  • The second link is to associate brokers that already have a Welltheos account
  • Copy the second link, log out of your agency portal, and paste that link into your browser
  • Follow the on-screen instructions
  • When enrolling customers, you will still need to use a broker profile, as the agency profile does not yet have any place for FFM username. This will require logging in to your broker profile and then associating it via the second link within your agency portal.
How do I create and associate a new Welltheos broker portal if I have an agency portal?
  • Once you log in, please find your way to the Broker Overview tab on the left. Within that tab will be 2 links.
  • The first link is to set up new brokers that you want to associate with your agency.
  • Copy the second link, log out of your agency portal, and paste that link into your browser
  • Follow the on-screen instructions
  • When enrolling customers, you will still need to use a broker profile, as the agency profile does not yet have any place for FFM username. This will require creating a broker profile and then associating it via the first link within your agency portal.
How do I change my logo?
  • Once you log in, go to the "Branding" tab on the left side
  • Under the "Upload Your Logo" section, you can choose a new logo that is 200px x 39px in png, jpg, tiff, or gif format
  • Once you have a new logo that appears in the preview box, click the "Upload" button
  • Your new logo will now appear in the upper left corner on all of your pages and on your associated broker's pages.
How do I change my theme color?
  • Once you log in, go to the "Branding" tab on the left side
  • Scroll down to the "Select Your Theme" section, and you can preview any of the colors that are shown
  • Once you find your preferred color, click the button marked "Save (Color) Theme".
How do I change my contact information?
  • When logged in, click on the "Broker" tab at the top of the screen
  • Click on the "Account Info" button on the left tab
  • From here, you are able to change your contact information including First and Last name, Email address, Phone number, and Exchange Username
  • You can also create your unique URL here
  • You cannot change your Agency name unless you are the agency, and then contact us at info@welltheos.com.
I'm an independent broker- do I need an agency portal?
  • The agency portal contains many features, such as the ability to brand the site with your own logo, and change the theme. It also has advanced analytics and the ability to export that information for reports.
I'm a broker- how do I see what enrollments have gone through?
  • Under your Subscriber Overview tab, you will be able to see the Name, Exchange ID, Premium, and Effective Date of your enrollments.
I'm an agency- how do I enroll customers?
  • At this time, you will need a separate broker account. The Agency Portal does not have provisions for FFM username.
I have an agency account- can I enroll customers in healthcare?
  • Unfortunately, the agency portal is mainly for branding your portal and receiving detailed analytics on your brokers and book of business. You will need an associated broker account for that.
Your subsidy estimator is slightly off from what my customer actually received from Healthcare.gov- why is there a discrepancy?
  • Our Advanced Premium Tax Credit (APTC) estimator takes into account the federal poverty level (FPL), the second cheapest Silver plan in your area, and several other general factors. When you enroll through Healthcare.gov, the questions that you have to answer are much more detailed, and therefore you will get a subsidy that might differ. Welltheos does not determine the eligibility for enrollment or subsidy.
How do I email or link quotes to a client?
  • Make sure you are logged in as a broker
  • On the top, click on the "Individual & Family Plans" tab
  • Enter in family information and search for a plan
  • In the upper left, you can see the three icons for Email, Link or Print These actions will attach your NPN to all quotes so if they decide to enroll, you will get credit
  • Additionally, if you are comparing plans, you can Email, Link, or Print the different plan comparisons with the same icons in the upper right corner of the screen These actions will attach your NPN to all quotes so if they decide to enroll, you will get credit
Why do carriers show up in my Individual and Family Plan shopping when I'm not appointed with them in my Broker Profile?
  • CMS regulations require that the client facing site must display all plans and carriers available to your client within their coverage area. All Web Broker Entities (WBEs) must comply with these regulations.
  • If a client chooses a plan that you are not appointed to sell, the enrollment may be completed, but you will not receive commission.
What happens after I enroll through Healthcare.gov?
  • Once you have submitted your application through Welltheos, your enrollment will be sent to Healthcare.gov. The insurance carrier is then notified and will proceed to seek binder and premium payments, issue ID cards and commissions. Welltheos is not in contact with the insurance carrier directly. If you come across a situation where your enrollment was submitted but not received by the insurance company, first check that the enrollment is listed in your "Subscriber Overview" tab. If the enrollment is verified, contact Healthcare.gov directly to escalate the issue.
How do I receive my commission?
  • All commissions are the responsibility of the broker and the insurance carrier, and not Welltheos. If you are logged in as a broker, then your NPN will be auto-populated on Healthcare.gov. It is also the responsibility of the broker to verify and make sure that it is auto-populated with the correct information. If proof of enrollment is needed from the insurance carrier, you may export your information in CSV format by first clicking on the "Subscriber Overview" tab, and then clicking "Generate Report."
How does my client receive ID cards?
  • After the application is submitted and the binder payment is made, the insurance carrier with mail ID cards to your client. The insurance cards typically take 2-4 weeks to arrive. If the client has any issues obtaining the ID cards, contact the insurance carrier directly.
What is the difference between Welltheos and the Federally Facilitated Marketplace (FFM)/Obamacare?
  • Welltheos offers an improved user experience by simplify the process and reducing redundancies normally experienced through healthcare.gov. Welltheos also offers improved broker tools to help manage and maintain your applicant's information.
  • Welltheos allows you, a licensed broker, to enroll quickly and easily. You can easily shop plans and estimate subsidies, email, or link specific plans to your clients, and it will auto-populate your NPN to get credit for the enrollment. When you enroll a client in a plan through Welltheos, you're enrolling in the Federal Marketplace.
Does Welltheos work with State-Based Exchanges?
  • Due to regulations imposed by the Centers for Medicare and Medicaid Services (CMS), Welltheos only permitted to work in the 37 Healthcare.gov states.
Who can I enroll through Welltheos?
  • Most clients can submit applications and enroll with Welltheos, but there are a few exceptions. Due to guidelines from CMS and Healthcare.gov, these cases cannot be handled by Welltheos and need to be enrolled directly with Healthcare.gov:
  • Dependent only applications, where only dependents in the household are seeking coverage.
  • Catastrophic plans
  • American Indians and Alaska natives, who are part of a federally recognized tribe.
When redirected back to Welltheos, the client's application cannot be enrolled. The final enrollment page on Welltheos says that no one on the application is eligible for coverage. Why can't Welltheos enroll them?
  • If redirected back to Welltheos to finalize the enrollment and the client is then told that no one on the application can be covered, that generally means that the client is ineligible. Based on what the client filled out on the application when redirected to Healthcare.gov, the client may not have entered a valid Special Enrollment Period reason. At that point, if the application cannot be enrolled, we provide the FFM application ID number on the final enrollment page and advise the agent and the client to call Healthcare.gov to find out the exact cause behind non-enrollment.
What errors can cause enrollment errors or pending applications?
  • Due to the re-direct to Healthcare.gov, the quantity of errors that can hold up an application is low. However, one common error is a disparity between quoted county and the client's actual county.
  • The broker would need to fill out a new enrollment application with the plan from the actual county.
When my client is redirected back to Welltheos, an error "oops" page or a red banner on the Welltheos enrollment page says that this application could not be enrolled at this time. Why did this happen? What should we do?
  • The error page and red banners occur due to a technical issue at Welltheos and/or Healthcare. gov. To help us pinpoint the issue, please reach out to info@welltheos.com with the applicant's first and last name and any details that may help us identify and resolve the issue.
An application was submitted and my client received a confirmation email. However, the client does not appear in my "Subscriber Overview." Why did this happen and am I the agent of record (AOR)?
  • If the client was enrolled and their application is not displayed on your agent dashboard, it could mean one of the following:
  • The client's application was not submitted using your agent branded link.
  • You were not logged in while completing the application.
  • If the client does not appear in your broker dashboard, it means that you are not attached as the AOR.
  • If your NPN was attached to the application and it is not showing up in your Subscriber Overview tab, please send us all as much information as possible and we can manually associate the application to your broker portal
How do I change my language?
  • In the upper-right corner of the screen is the "Language" drop-down button. Click that and select "View in English" or "View in Spanish".

Special Enrollment Confirmation Process

What is the Special Enrollment Confirmation Process?
  • Special enrollment periods (SEPs) are an important way to make sure that people who lose health insurance during the year or who experience major life changes like getting married or having a child have the opportunity to enroll in coverage through the Health Insurance Marketplaces outside of the annual Open Enrollment period. SEPs are a longstanding feature of employer insurance, and without them many people would lack options to maintain continuous coverage. But it's equally important to avoid SEPs being misused or abused.
  • At CMS, we are always monitoring the health and operations of the Marketplace and looking for ways to improve. We are focused on continually maintaining and refining a set of Marketplace rules that create a healthy, stable, and balanced risk pool. Concerns have been recently raised about whether current Marketplace rules and procedures are sufficient to ensure that only those who are eligible enroll through SEPs. In response to that feedback, today we are announcing a new Special Enrollment Confirmation Process that will address these concerns in the 38 states using the HealthCare.gov platform. These changes will enhance program integrity and contribute to a stable rate environment and affordability for consumers.
  • Once the new Special Enrollment Confirmation Process is implemented, all consumers enrolling through the most common HealthCare.gov SEPs will need to submit documentation to verify their eligibility to use an SEP. The Special Enrollment Confirmation Process will be accompanied by other improvements to the SEP application process, described below. Today's announcement represents a major overhaul of the SEP process.
  • Over the next few weeks, CMS will invite comment from consumer advocates, insurance companies and other stakeholders on the key features of the new Special Enrollment Confirmation Process, such as communication with consumers, acceptable documentation, and refining and targeting the verification process. These comments will help inform implementation of the new process. This announcement builds on action CMS has taken to eliminate unnecessary SEPs and clarify the rules for other SEPs.

How Special Enrollment Confirmation Works

Document Submission by Consumers
  • Beginning in the next several months, all consumers who enroll or change plans using an SEP for any of the following triggering events will be directed to provide documentation:
  • Loss of minimum essential coverage, Permanent move, Birth, Adoption, placement for adoption, placement for foster care or child support or other court order, or Marriage.
  • These SEPs represented three quarters of HealthCare.gov consumers who enrolled or changed plans using an SEP in the second half of 2015.
  • We will provide consumers with lists of qualifying documents, like a birth or marriage certificate. Consumers will be able to upload documents to their HealthCare.gov account or mail them in.
Document Verification by CMS
  • CMS will institute a verification process for consumers who enroll or change plans using an SEP in 2016. The Special Enrollment Confirmation Process is modeled after approaches used by the Internal Revenue Service. We will review documents to ensure consumers qualify for an SEP and will follow up with consumers if there is a question or problem. Consumers need to be sure to provide sufficient documentation. If they don't respond to our notices, they could be found ineligible for their SEP and could lose their insurance.

Implementing the Special Enrollment Confirmation Process

Implementing the Special Enrollment Confirmation Process
  • As we move forward with implementing the Special Enrollment Confirmation Process, CMS intends to work closely with our enrollment partners. We invite feedback on:
  • Communicating with consumers about providing required documents: As CMS implements the Special Enrollment Confirmation Process, we will work closely with enrollment partners to ensure our notice language is clear about what documents a consumer should submit and how those documents can be submitted. We also invite feedback on best practices for communicating with consumers regarding what documents can be used to establish eligibility for different SEPs.
  • Refining the confirmation process: We invite feedback on how our verification efforts respond to areas where there is the greatest risk of SEP misuse.
  • Training assisters, agents, and brokers: CMS will develop resource guides for advocates, assisters, agents, and brokers to help them understand the Confirmation Process, acceptable documents, and situations in which consumers do and don't qualify for SEPs.
  • Feedback on the Special Enrollment Confirmation Process should be sent to SEP@cms.hhs.gov.

What Else CMS is Doing to Improve Program Integrity for Special Enrollment Periods

What Else CMS is Doing to Improve Program Integrity for Special Enrollment Periods
  • Requiring consumers to acknowledge document request and reminding consumers of the need to be truthful: In the next few weeks, HealthCare.gov will require all consumers who enroll or change plans through an SEP to indicate they understand that documents will be requested to verify their SEP eligibility. This process will begin in the coming weeks and will ramp up over time and continue expanding once the Special Enrollment Confirmation Process is fully in place. Consumers must also attest at the end of their HealthCare.gov application that they are providing true information and understand the penalties for misrepresentation. We'll be updating the application to include additional attestation language so that consumers understand that they are required to be truthful and risk losing their eligibility for Marketplace coverage.
  • Clarifying application questions for consumers: In the coming weeks, we'll be updating HealthCare.gov to make it clearer for consumers who are submitting or updating an application to understand what does and doesn't qualify as a loss of minimum essential coverage, and a permanent move. Here are a couple of examples:
  • Call 1-800-318-2596 to report Fraud or abuse: Anyone who suspects that there has been fraud or abuse in the Marketplace should call 1-800-318-2596 to report their concerns. Simply indicate that you are calling about fraud and abuse and CMS investigators will receive the complaint.

Last Updated: Friday, November 02, 2018