Worksheet
Portrait + landscapeAPTC and CSR Coordination Worksheet
Organizes facts and review questions involving premium tax credits, cost-sharing reductions, and HRA eligibility.
Resource Library
Evaluate Coverage & Marketplace Fit
Review individual market plans, networks, costs, subsidies, geography, and participant coverage needs.
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Decision Record
Portrait + landscapeCoverage Coordination Complication Record
Capture a participant coverage-coordination issue, affected plans, unresolved facts, and the specialists or partners responsible for next steps.
Decision Record
Portrait + landscapeCoverage Coordination Routing Record
Record where a coverage-coordination question was routed, why that destination was selected, and what follow-up evidence is expected.
Evidence File
Portrait + landscapeMarket-Fit Issue File
Documents a coverage-market concern, supporting facts, escalation needs, and the resolution path.
Reference
Portrait + landscapeMarket-Fit Review Triggers Card
Recognize geographic, network, premium, carrier, and participant signals that should trigger a fresh market-fit review.
Guide
Portrait + landscapeMarketplace Plan Selection Guide
Guides comparison of individual-market plans using cost, network, coverage, and participant needs.
Flyer
Portrait + landscapeMetal Tier Comparison Flyer
Explains how marketplace metal tiers generally differ in cost-sharing structure and participant tradeoffs.
Checklist
Portrait + landscapeNetwork, Provider, and Drug Verification
Supports verification of provider networks, facilities, prescriptions, and other coverage needs before enrollment.
Decision Record
Portrait + landscapeOn/Off-Exchange Decision Record
Documents the factors and rationale behind an on-exchange or off-exchange coverage decision.
Checklist
Portrait + landscapeParticipant Decision Support Checklist
Helps participants consider plan costs, networks, prescriptions, household needs, and enrollment support questions.
Reference
Portrait + landscapePlan Types and Network Access Reference
Summarizes common individual-market plan types and the network-access considerations associated with them.
Reference
Portrait + landscapeRegulatory and Market Data Feeds
Identify external regulatory and market data sources, their owners, update frequency, quality limits, and uses in coverage evaluation.