Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 07, 2017

Program Area: Enrollment and Eligibility (ENR)

Question: How should issuers handle the increase in the number of Health Insurance Casework System (HICS) cases for the 2017 Plan Year (PY)?

Answer: During January and February of each year, duplicate enrollments become visible to consumers, which can contribute to an increase in HICS cases and enrollee requests. For example, an issuer can receive requests directly from the enrollee to cancel a passive reenrollment (policy origin of 11). If no claims are pending on that policy, the issuer may retroactively cancel the policy. If issuers receive a HICS case instructing the issuer to cancel the passive reenrollment, the issuer should follow the HICS and the passive reenrollment should be cancelled. An enrollee who wants to end any active enrollment must make the request at the Marketplace. The HICS Exchange Issuer Best Practices 2018 can be found on REGTAP here: https://www.regtap.info/reg_librarye.php?i=2344

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