Shopping for a plan, can be tough but with guidance we’re here to help. Glossary of definitions can be found here.
Navigating this article:
Getting Started:
My Info: Personal Info
Profile information needs to be entered for you and and family members who will be covered under the medical insurance plan if applicable.
You are then required to acknowledge legal documents, which will be stored in your portal.
Review your HRA documents: Be sure to review them so you can understand and make the most of your new HRA benefit! Please read the Employee Notice for important information about how it may affect your eligibility to receive a premium tax credit. But don't worry - we'll walk you through it! At any time, you can return to the dashboard.
Medicare
Please proceed here if you are Medicare eligible
Medicaid:
(If you are enrolled in Medicaid, you will be routed to the waive questions as your are not eligible to participate in an HRA. Employees need to be enrolled in insurance that is considered individual health insurance. Medicaid does not fit this type of insurance and does not qualify as a participating plan for the ICHRA benefit.)
Waive:
You will be given the option to waive coverage via the popup modal or waive link if you do not want to participate in the HRA offering being provide by your employer. You will be asked to share the reason for your decision to waive.
My Info: Doctors
The ‘Doctors,’ sections contains optional elements to help you find a health plan best suited for your needs. This sections allows you to search your preferred provider/specialist, and later we can advise if that provider is covered in each plan option. They will be added to your recommended plans.
Stepper: Look for "My Info" in green on the top stepper and the active step on the left navigation bar.
Search: Select a doctor based on the entered zip code in the previous step
Search by doctor or specialist name
Search by doctor address
Able add more than one doctor or specialist
Able to add different types of doctors or specialists
Once complete, review your selections and click Continue (or skip if you are not answering the question.)
What to Do If You Cannot Find Your Doctor?
If you encounter difficulties in finding your desired doctor, here are some troubleshooting steps to consider:
Verify Search Criteria: Double-check the search criteria provided, including the doctor's name, specialty, and location details such as address, city, or ZIP code. Ensure that the information entered is accurate.
Check Spelling and Details: Ensure that you have entered the correct spelling of the doctor's name and any other relevant details such as specialty or clinic name.
Verify Address: Double-check the address you entered. Minor errors in address input can lead to inaccurate search results. Ensure that the address is complete and accurate.
Contact Support: If you still cannot find your doctor, reach out to our customer support team for assistance. They can help troubleshoot the issue and provide alternative solutions or recommendations.
My Info: Hospitals
The ‘Hospital’ section contains optional elements to help you find a health plan best suited for your needs and works much like the doctors search.
Stepper: Look for "My Info" in green on the stepper and the active step on the left navigation bar.
Search: Select a hospital based on the entered zip code in the previous step.
Search by hospital or medical facility name: Name, Address, City, State
Search by hospital address
Able add more than one hospital or medical facility
Able to add different types of hospitals or medical facilities
Once complete, review your selections and click Continue (or skip if you are not answering the question.)
What to Do If You Cannot Find Your Hospital?
If you encounter difficulties in finding your desired hospital or medical facility, here are some troubleshooting steps to consider:
Verify Search Criteria: Double-check the search criteria provided, including the hospital or facility’s name, specialty, and location details such as address, city, or ZIP code. Ensure that the information entered is accurate.
Check Spelling and Details: Ensure that you have entered the correct spelling of the hospital’s name and any other relevant details such as specialty or clinic name.
Verify Address: Double-check the address you entered. Minor errors in address input can lead to inaccurate search results. Ensure that the address is complete and accurate.
Contact Support: If you still cannot find your doctor, reach out to our customer support team for assistance. They can help troubleshoot the issue and provide alternative solutions or recommendations.
The ‘prescriptions’ sections are optional elements to help you find a health plan best suited for your needs. This document will cover details regarding medication search and handling situations where you cannot find your prescription within our system.
My Info: Prescriptions
Stepper: Look for "My Info" in green on the stepper and the active step on the left navigation bar.
Search: Select a prescription based on the entered zip code in the previous step.
Search by medication or prescription
Search by prescription: ongoing use for prescriptions, branded vs generic, prescriptions by dose. Input details such as the medication name, dosage amount (e.g., mg or ml) and frequency of intake provided by your healthcare provider. The best practice is to check the actual label on your prescription packaging.
Able add more than one medication or prescription
Able to add different types of medication or prescription
Once complete, review your selections and click Continue (or skip if you are not answering the question.)
What to Do If You Cannot Find Your Prescription?
If you encounter difficulties in finding your prescription or routine medication, consider these troubleshooting steps:
Double-Check Information: Ensure that you've entered the medication name correctly. Check for any alternative names or generic equivalents that may be listed under different terms.
Contact Support: Reach out to our customer support team for assistance. Provide them with details about the medication you're trying to find, including the name, dosage, and any other relevant information.
My Info: Family
The ‘Family’ section allows you to add. edit or delete the family member that you would like to include in the health plan coverage you are selecting, and determines your monthly allowance.
Add, Edit, or Delete: Users can add, edit, or delete family members they wish to include in their health plan coverage. Spouses and dependents are added individually.
Employee Card Tags: The employee card contains essential tags such as Date of Birth (DOB), Name, Employee/Family Member Type, ZIP Code - County, Doctor, Hospital, and Prescriptions. Users can edit and delete family members but cannot remove their employee card.
Age and Dependency Criteria: If a dependent is over the age of 26, no plans will appear, as they are no longer eligible for coverage under most plans. Similarly, if there is a disabled dependent over 26, they will not be included in the plan selection process.
Family Members: If the employee has Medicare, Medicaid, or a family member residing in a different ZIP code, the platform will display a warning message. This message alerts the employee to additional considerations when selecting and purchasing health insurance plans.
Adding, Editing, and Deleting Family Members
To manage your family members within the health plan coverage, follow these instructions:
Adding Family Members:
Locate the option to 'Add a New Family Member' and click + sign
Enter the required information for the family member, including their name, relationship, date of birth, and other relevant details.
Once you've entered all necessary information including doctors, facilities and prescriptions, click 'Save' to add the family member to your coverage.
If you have family members in a different zipcode, see here for "split family shopping" information.
Editing Family Members:
In the 'Family' section, locate the family member you wish to edit.
Next to the family member's information, you'll see a pencil icon.
Click on the pencil icon to access the editing options.
Update the relevant information for the family member as needed.
After making the changes, click 'Save' to confirm the edits.
Deleting Family Members:
Within the 'Family' section, find the family member you want to remove from your coverage.
Adjacent to the family member's details, you'll see a trash icon.
Click on the trash icon to initiate the deletion process.
A confirmation prompt will appear to ensure you want to delete the family member.
Confirm the deletion, and the family member will be removed from your coverage.
After adding family members and entering necessary details, review 'employee card' tags, confirming accuracy and selections. Once complete, click 'Continue' to proceed to Household income.
My Info: Household income
The section allows you to enter your total annual household income to help Take Command assess if you are eligible for tax credits. You can use the salary estimation tool to enter your hourly rate, hours per week, and weeks per year to help determine the annual income for your household.
What is total household income and how is it used?
Total household income is the combined earnings of everyone in your household. It's used to determine eligibility for certain benefits and subsidies, like healthcare tax credits when selecting a health plan. Each covered working family member’s income needs to be included in the annual household income, similar to how it is complete for IRS filings.
With the household income added, the Take Command system will complete a review of the information and advise the users of their eligibility.
It's very important to remember that you cannot accept a premium tax credit if you are claiming reimbursement through ICHRA. Here is a little more about how ICHRA affects your tax credit.
Tax credits
Regarding tax credits, it is important to take into consideration whether or not your ICHRA offer is considered "affordable."
If it is deemed affordable, then the employee cannot accept tax credits.
If it is deemed unaffordable, the employee can choose to either accept tax credits or the ICHRA reimbursement, but not both.
If an employee accepts the HRA offer, the employee can still shop for a plan, click ‘Show all plans’ to continue.
The Exchange website will provide individuals information on how to determine affordability for ICHRA.
If tax credits are available to you and you choose to accept them and continue shopping, the Take Command platform will only show you plans that are available on exchange. You will be directed to enroll in that plan separately from our website.
When you enroll in health insurance coverage through the Exchange, the Exchange will ask you about any coverage offered to you by your employer, including through an HRA. Your ability to claim the premium tax credit may be limited if your employer offers you coverage, including an HRA. Lastly, the employee also has the option to accept the HRA offer and waive coverage.
Choosing a plan
Shopping for a plan, can be tough.
Take Command Health is here to help!
Recommended Plans:
The ‘Recommended plans’ section allows you to view recommendations based on your preferred doctor(s), hospital(s), and prescription(s) pre-selections. This provides you with only plans that meet your specific needs.
These are displayed on the first page for your convenience. To explore additional options, simply scroll down and click "Next" to view more plans.
If no plans match all of the entered preferences, the system will automatically keep the filters and display a blue toaster:
*You can ‘clear all' filters to view all plans based on your zip code and county.
Filtering and sorting
Filters allow employees to narrow down options with multiple selections. You'll also be able to filter out the many options based on your preferences for insurance carriers, doctor networks (PPO, EPO, HMO), and the ease of enrollment.
Doctor with location: The Doctor Search tool is used to help determine if your selected doctor or specialist is in or out off network. Keeping your favorite doctors "in network" is critical to saving money. If you try to see a doctor that is out of network, your health plan won't help very much or may not pay anything at all.
Plan type
EPO (Exclusive Provider Organization): Hybrid of PPO and HMO. Enjoy lower premiums compared to PPO plans, and a referral is not required to see a specialist.
HMO (Health Maintenance Organization): Lower monthly premiums are offered, but you must get a referral from your Primary Care Provider (PCP) before seeing a specialist.
PPO: Most flexible, yet most expensive network type. Do not need a referral to see a specialist. Option to see doctor outside preferred network.
Carrier: based on ZIP Code searched and carriers available in the selected area.
Metal tier:
Platinum: covers 90% on average of your medical costs; you pay 10%
Gold: covers 80% on average of your medical costs; you pay 20%
Silver: covers 70% on average of your medical costs; you pay 30%
Bronze: covers 60% on average of your medical costs; you pay 40%
Extended Bronze: Catastrophic policies pay after you have reached a very high deductible ($8,700 in 2022). Extended Bronze plans must also cover the first three primary care visits and preventive care for free, even if you have not yet met your deductible.
HSA Eligible: This is a tax-advantaged account that allows you to put tax-deferred dollars into an account. At age 65, you may make eligible withdrawals from the account tax-free.
Enrollment Types:
Easy Enroll: Plans with this tag will have an easy, fast enrollment! This means that you can complete the enrollment directly on the Take Command Health site, and we will even set up your recurring claim for you automatically. Take Command Health can provide additional support to you if anything comes up on your plan. We can work with the carriers on your behalf!
Self Enroll: For these plans, you'll need to enroll on your own, either directly with the carrier or with your state exchange. We will still help you narrow down which plan is best and then guide you on where to go from there. If an issue comes up with your plan, you'd need to call the carrier directly. We can always help provide guidance on how to do that, though.
You can also sort available plans by premium, max out of pocket, deductible in addition to low to high and high to low sorting.
Compare Plans: Utilize side-by-side comparison features to evaluate the pros and cons of each plan comprehensively
Plan card details
The ‘plan cards' provide a summary level of information for each healthcare plan, including costs and key features. These details showcase all of the information we have on each carrier and plans. The plans available to you are based on your zip code and county combination. On the plan cards, detailed information about the number of matching doctors, hospitals, and prescriptions will be shown when you hover over each one.
If no plans match the user’s filters but filters were applied, plans will still be shown, and the plan cards will indicate "Providers: 1" or similar, where appropriate.
Monthly Premium: The monthly fee required for coverage.
Deductible: The amount you must pay out of pocket before your insurance starts covering costs.
Max Out-of-Pocket: The maximum amount you'll have to pay for covered services in a plan year.
"My Cost" if Premium Exceeds Allowance: This represents the difference between your allowance and the premium. It indicates what you would need to cover beyond your provided allowance.
Remaining Allowance: The remaining portion of your allowance after deducting the premium. You can use it to pay for eligible medical expenses.
View and Print Details
You can view and print the details of a plan for offline reference.
Plan Overview: The plan is in full detail similar to the attached PDF.
Cost breakdown: The amount you pay or the amount your allowance covers for your expenses
Doctors: Presented based on the plan's network and coverage.
Prescriptions: This represents the in-network or out-of-network prescriptions cost written by healthcare providers.
Hospitals: Hospitals are medical facilities equipped with specialized staff, equipment, and resources to provide diagnosis, treatment, and care for a wide range of illnesses, injuries, and medical conditions.
Mental Health: Mental and behavioral health inpatient services involve comprehensive treatment and care provided within a hospital setting for individuals experiencing acute psychiatric conditions or severe mental health crises.
Pregnancy & Maternity: Includes Inpatient birth refers to the process of childbirth that occurs within a hospital or medical facility where the mother stays overnight for monitoring and medical care before, during, and after delivery, postnatal and prenatal care.
Emergency Care: Refers to immediate medical attention provided to individuals who are experiencing sudden and often serious medical conditions or injuries that require urgent treatment. This care is typically provided in hospital emergency departments or urgent care.
Tough Choices
Making decisions about healthcare can be complex, but rest assured that you're not alone in this process. Our platform is designed to provide clarity and support every step of the way. Remember, by carefully considering your needs and priorities, you can confidently narrow down your options and select the plan that offers the best value and coverage for you and your family.
We have an Enrollment team ready and available to assist you in selecting a plan. Please schedule a time with them here, on our Enrollment Team Call Calendar.
Completing Your Insurance Plan Purchase
You're almost there!
After selecting your plan, it's time to take the final steps to purchase your insurance and receive confirmation. Here's a simple guide to make sure everything goes smoothly.
(If you selected a 'self enroll' plan, and your company has Autopay, proceed here)
(If you selected a 'self enroll' plan, and your company does not have Autopay, proceed here)
Upcoming:
1. Insurance Carrier questions:
Once you've chosen your plan, you may need to answer some insurance carrier-specific questions. These are required for completing the specific carrier application. Don't worry; Take Command handles this for you, ensuring all necessary questions are included. Once these questions are answered, click continue to ‘Mailing Address’.
2. Mailing address:
In the application process, you have the option to keep your mailing address the same as entered or update it as needed. Here's how you can manage your mailing address effectively:
Keeping the Same Address:
If you wish to keep your mailing address unchanged from a previous entry, simply click continue.Editing the Address:
If you need to make changes to your mailing address, you can "edit" directly on the form. This allows you to modify the address details as required.Saving Progress:
The application automatically saves your progress when you click "continue." This ensures that your mailing address choice is recorded and maintained throughout the application process.Validation and Error Handling:
To maintain accuracy and compliance, the application requires all fields to be valid and filled out before allowing you to continue. If any errors occur, such as an invalid address format or the presence of a P.O. Box, the application will prompt you with a red error message: "Address invalid. Enter a valid address. P.O. Boxes are not allowed."
Click continue to continue to the next page in the application process.
3. Additional Information Required for Purchase:
To proceed with purchasing your health plan, you'll need to provide some additional information, including Social Security Numbers (SSN) for everyone covered under the plan, including dependents under 18. Your Social Security Number (SSN) is required for carrier application submission for identification and verification purposes.
4. Applicant Signatures:
For each individual selected for a health plan, you'll need to provide a digital signature. This ensures that everyone included in the plan acknowledges and agrees to the health plan selection. Here's how you can do it easily with our user-friendly digital signature feature.
Signature Field for Each Shopping Person:
Adults or those over 18 years old will need to sign individually.
Each signature field is tailored to the person selected for the health plan, making it easy to confirm their choice.
Validation of Input Fields:
Before proceeding, ensure that all required input fields, including signatures, are filled out accurately.
The "continue" button will remain disabled until all input fields are valid, preventing any errors.
Seamless Navigation:
If you need to make changes or review sensitive information such as Social Security Numbers (SSNs), you can easily navigate back to the relevant sections.
Once all signatures and input fields are complete and valid, proceed forward to the final summary plan.
5. Summary and Purchase:
Next, you’ll land on the final summary page.
During this stage, it is recommended that you complete the following:
View Summary and Make Changes: Review your selections and make any necessary adjustments, such as going back to remove or add a different plan.
Save to Complete Later: If you need more time, save your progress to complete the enrollment at a later time by returning the dashboard at any time.
Complete Enrollment: Once satisfied, proceed to complete enrollment. Upon successful completion, you'll receive a printable "success" screen.
6. Purchase a plan with CC or ACH:
If you selected an 'easy-enroll' plan, you will now be directed to the Payment Details page (unless your company is enrolled in Autopay). On this page, you will securely enter your payment details by choosing between credit card (CC) or ACH.
Once the payment information is submitted, you will be routed to the "Additional Premiums" page to complete the next steps of the enrollment process.
Jump to --> Upload additional premiums
7. Final Success Page
Depending on your employer's preferences, the "success" screen may offer the option to select a dental partner for dental insurance needs. These partners have dedicated landing pages for users to complete the application process directly with the dental carrier.
After completing the purchase of your medical insurance plan, you'll receive an automated message confirming your successful enrollment. Your portal will be promptly updated with the new information, providing reassurance that your insurance coverage is secured.
