2022 Open Enrollment Marketplace Kickoff Event September 29th, 2021
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2022 Open Enrollment Marketplace Kickoff Event September 29th, 2021
Benefits of Small Business Health Options
Small Business Basics
• Guarantees small businesses the ability to offer employee
health plans, regardless of pre-existing medical conditions
• All plans cover essential health benefits established by the
Affordable Care Act
• Offers a choice of comprehensive health and dental plans,
provided by private insurance companies
• Participating businesses may be eligible for a tax credit
worth up to 50 percent of their contributions
2022 OE Marketplace Kickoff Event 3
Small Business Features
• Select a base plan and give employees the option to choose a plan from any
metal level
• Ability to contribute either a set dollar amount or percentage of the employees'
premium – as little as $0 per month or as high as 100% of the premium
• There is no minimum participation requirement to be eligible for coverage
• Start coverage any time of the year
• One Premium Statement
• Three health insurance carriers , with 54 different plan designs to choose from.
One dental carrier with 12 different plan designs
True Health New Mexico
Presbyterian Health Plan
Presbyterian Insurance Company
Best Life Dental
2022 OE Marketplace Kickoff Event 4
Website
BeWellnm.com – Home Page
• Goes live October 1, 2021
• Access the 2022 Coverage Login
checkbox to apply or reenroll for
coverage.
Important Tips:
• Look for the beWellnm registered
trademark.
• When searching on the web, look for
the beWellnm.com site that states
official site.
2022 OE Marketplace Kickoff Event 6
Website-Educational & Outreach Material
• BeWellnm has educational material
available for community use.
• If you are having an event, and or
would like to share this information,
please download from our site, or
place a request for printed material.
2022 OE Marketplace Kickoff Event 7
Individual/Family Marketing Material 2022 OE Marketplace Kickoff Event 8
Get Help Features
• Virtual Appointments: Consumers can set up an appointment with a
broker or enrollment counselor. Available at www.beWellnm.com
• Help On Demand: Consumer requests assistance and an active
referrals is made to brokers and or enrollment counselor. Response
expected in 15 minutes. Available at www.beWellnm.com and
throughout the online application.
• Locate a Certified Assister. Online tool to find a broker or enrollment
counselor based on location and languages spoken. Available at
www.beWellnm.com and throughout the online application.
2022 OE Marketplace Kickoff Event 9
Resources
• Learn More- Knowledge • Broker User Manuals
Base articles • Enrollment Counselor
• Training User Manual
• Forms • Consumer User
Manual
• Policy Manual
2022 OE Marketplace Kickoff Event 10Outreach & Education Team 2022 OE Marketplace Kickoff Event 11
Outreach & Education Team
Misti Dickens Katrina Smith Debra Gassoway
Community Engagement Community Engagement Outreach Project
Specialists Specialists Manager
505-314-5262 505-314-5205 505-314-5227
mdickens@nmhix.com ksmith@nmhix.com dgassoway@nmhix.com
Adriano Lujan Juliet Yazzie
Community Engagement Native American
Specialists Liaison Manager
505-314-5220 505-314-5261
alujan@nmhix.com jyazzie@nmhix.com
12Community Engagement
Community Engagement Specialist
Specialist
(CES) Territory
The CES is a champion. They will champion beWellnm
when in communities, and champion communities
when at beWellnm.
• AL-Adriano Lujan
• KS-Katrina Smith
• MD-Misti Dickens
13Customer Engagement Center 2022 OE Marketplace Kickoff Event 14
Customer Engagement Center
• Local located in downtown Albuquerque.
• Service Features
– One stop shop for all services
– Return call back option
– Chat
2022 OE Marketplace Kickoff Event 15Overview
BeWellnm will provide two levels of call resolution.
– First tier calls such as, account information, application help,
education, guidance, complaints & grievances will be handled by
a Customer Engagement Center representative managed by NFP.
– Second tier calls such, as complex eligibility issues or appeals. And
or Premium payments by phone or questions about billing
statement will be handled by beWellnm internal escalation and or
premium billing team.
Presentation 1 16How consumer issues will be addressed
BeWellnm is focused on providing quality service to our New Mexico consumers. The goal is to provide a one call resolution
experience, and to ensure we don’t bounce callers between various call centers such as the QHPs and or HSD.
For example:
– If a call is incorrectly transferred, from a QHP to beWellnm the customer engagement center representative will
document the issue and work with their internal supervisor to get resolution to the correct organization for an outbound
call resolution.
– A consumer calls the carrier because they were denied a service. Carrier call center reviews the issue and initially
determines they are not enrolled – perhaps because of an eligibility issue. The call is transferred to beWellnm Customer
Engagement Center its determined that the person is currently eligible and enrolled in the Carrier’s heath plan.
• Customer Engagement Center representative documents the issue, escalates to internal staff for work with the
carrier to clarify the eligibility and enrollment status. Carrier calls the consumer to provide the updated
information.
– Consumer is seeking immediate medical care. They need to pay an outstanding premium bill and they call the beWellnm
Customer Engagement Center, and a beWellnm specialist reinstates coverage and communicates the updated enrollment
status to carrier (prior to receipt of the update 834 file)
BeWellnm will maintain current points of contact to resolve issues for consumers.
Presentation 1 17beWellnm/NMHIX main number @ 1-833-862-3935 (as of 10.1.2021)
English and Spanish menu options in the IVR
Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8
If you are If you If you If you have If you are a If you If you If you
calling need to need a question Broker or a need to need help need to
about speak to password about certified make a with an speak to
Medicaid the FFM or account Enrollment enrollment payment Appeal the SHOP
help counselor
Routed to Routed to Routed to
HSD FFM SHOP
Routed to Routed to Routed to Routed to Routed to
CEC CSR CEC CSR CEC CSR CEC CSR CEC CSR
2022 OE Marketplace Kickoff Event 18Customer Engagement Center
www.beWellnm.com
Shop, compare, enroll and make a premium payment !
CHAT Services Provided
• Find Educational & Important information, resources & assistance
GOES LIVE OCTOBER 1, 2021
8 a.m. to 6 p.m. M – F (non-open enrollment)
Customer Engagement Center
1-833-ToBeWell (862-3935)
•Extended hours during Open Enrollment
7am to 7pm M-F and 9am-2pm Saturday
2022 OE Marketplace Kickoff Event 19You can also read
