Apply for an Exemption

 

Use this user guide to apply for an Exemption on behalf on an individual.

 

 

 

 

From the Home Page access the Admin Dashboard screen.

 

There are five valid reasons to apply for an exemption to the individual mandate: Qualifying Religious Exemption, Membership in a Healthcare-Sharing Ministry, Hardship (Financial or Non-financial), Incarceration and Membership in an Indian Tribe

 

 

 

 

 

 

Process Steps

 

To apply for an exemption:

 

1.      Click the Manage an Individual Account link in the Admin Dashboard.

 

·        The Account Search screen is displayed.

 

2.      Enter search criteria for the account whose member(s) is(are) applying for an exemption:

 

a.      Select Individual from the Role drop down menu.

 

b.      Enter the first name of the account’s primary applicant in the First Name textbox.

 

c.      Enter the middle name of the account’s primary applicant in the Middle Name textbox.

 

d.      Enter the last name of the account’s primary applicant in the Last Name textbox.

 

e.      Enter the date of birth of the account’s primary applicant in the Date of Birth textbox in the format MM/DD/YYYY or select it from the calendar.

 

f.       Enter the social security number of the account’s primary applicant in the Social Security Number textbox in the format XXX-XX-XXXX.

 

g.     Enter the account number in the Account ID textbox.

h.      Enter the Application Received Date from and the Application Received Date to fields in the format MM/DD/YYYY or select them from the calendar.

None of the fields to enter/select search criteria is mandatory; however, at least one must be selected or entered for the search to be completed.

 

 

3.      Click on the Search button.

 

·        Accounts that match the criteria are displayed.

 

4.      Select View Account from the Admin Functions drop-down menu and click Submit.

 

·        The Admin View of the Individual Account Dashboard is displayed.

 

5.      Click on the Tasks tab in the Admin View of the Individual Account Dashboard.

 

·        The Tasks tab is displayed.

 

If the applicant has started other tasks, such as an requesting an appeal, applying for an exemption or filing a complaint, they are displayed in this screen and can be updated by clicking on them.

 

 

6.      Click the Apply for an Exemption button.

 

·        The Request an Exemption to the Individual Mandate screen is displayed.

 

7.      Click Next.

 

·        The File an Exemption screen is displayed.

 

8.      Select the radio button adjacent to his/her name to indicate the member of the household applying for an exemption. If more than one member of the household is applying for an exemption, click the Add Another Member button and enter his/her information.

 

9.      Click Next.

 

·        The File an Exemption – Personal Information screen is displayed.

 

10.   Select a reason for the exemption in from the Reason for Exemption drop down menu. Options are: Qualifying Religious Exemption, Membership in a Healthcare Sharing Ministry, Incarceration, Membership in an Indian Tribe, Financial Hardship and Non-Financial Hardship.

 

11.   Click the Exemption link under the Type column to open the exemption to be acted on.

 

·        The Update Exemption Request screen is displayed.

 

12.   If Qualifying Religious Exemption is selected, enter the name of the religious group in the Religious Group textbox.

 

13.   If Membership in a Healthcare Sharing Ministry is selected, enter the name of the ministry in the Healthcare-Sharing Ministry Group textbox.

 

14.   If Membership in an Indian Tribe is selected, enter the name of the tribe in the Tribe Name textbox.

 

15.   If Financial Hardship is selected, enter the individual’s income in the Income textbox.

 

16.   If Non-Financial Hardship is selected, enter the reason in the Reason textbox.

 

17.   Enter the exemption start date in the format MM/DD/YYYY or select it from the calendar.

 

18.   Enter the exemption end date in the format MM/DD/YYYY or select it from the calendar.

 

19.   Enter additional notes in the Additional Notes and Comments textbox.

 

20.   If needed, upload supporting documentation for the exemption, by clicking the Browse button in the Upload Document section.

 

·        A browse window is displayed to select the documents from local files.

 

21.   Select the document category from the Document Category drop-down menu.

 

22.   Click the Upload button.

 

23.   Instruct the applicant to electronically sign the exemption request:

 

a.      Check the box to attest the applicant s electronically signing the application.

 

b.      Enter his/her first name in the First Name textbox.

 

c.      Enter his/her middle name in the Middle Name textbox.

 

d.      Enter his/her last name in the Last Name textbox.

 

24.   Click Submit.

 

·        The Exemption Confirmation pop-up is displayed.

 

25.   Click the Go to Dashboard button.

 

·        The Tasks tab of the Admin View of the Individual Account Dashboard is displayed.

 

 

Results of the Procedure

 

An exemption application is submitted.