3.10 Health Insurance

Contents

Step 1: Answer who currently has a health insurance policy
Step 2: Provide information on premiums and coverage dates
Step 3: Provide information on the insurance company
Step 4: Provide additional information about the household member’s insurance source
Step 5: Additional health insurance
Step 6: Answer who has access to health care coverage
Step 7: Provide information on the source of the available insurance
Step 8: Confirm information on the Summary page

Use these instructions to help people answer questions about their health insurance. This section is only included if the application includes health care or FoodShare.

A variation of this section is included for Katie Beckett Medicaid applications that only asks questions about the policies for the children requesting Katie Beckett Medicaid.

Once completed, the applicant can review the section for accuracy before going to the next section.

Step 1: Answer who currently has a health insurance policy

These pages ask about the household’s current health insurance. The pages appear for FoodShare applications, Medicaid, FPOS and BadgerCare Plus applications.

The “Health insurance policy holders” page asks if any household members currently have health insurance.
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Questions	How to answer
Does anyone have a health insurance policy that covers one or more people in your household?	Select Yes or No. Answer yes even if the person with insurance is not on this application. This question is optional for those only applying for FoodShare. If the applicant selects yes, the next question displays.
Who is the owner of the health insurance policy?	Select the owner of the health insurance policy. If someone outside of the household owns the insurance policy, select Someone else. This question is optional for those only applying for FoodShare.

If someone outside of the household holds the insurance policy the applicant will be asked to provide their information (Click to show)If someone outside of the household holds the insurance policy the applicant will be asked to provide their information (Click to show)

The “Other policy holders” page asks about the individual outside the household who covers people in the household.
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Questions	How to answer
Name	Enter the full legal name of the individual.
Sex	Select Male or Female.
Date of birth	Select the date from the calendar.
Does anyone else have health insurance that covers one or more people in your household? (Optional)	Select Yes or No.

If more than one person in the household has a health insurance policy, the “Your household’s health insurance” page displays. This page asks the applicant to select which household member’s health insurance information to enter first.

The applicant is brought back to this screen until all the individuals who have health insurance are completed.
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Questions	How to answer
Choose who you’d like to tell us about first.	Select Start next to someone’s name to begin asking questions for that person. The applicant is brought back to this screen until all the questions for individuals who have health insurance are completed.

Step 2: Provide information on premiums and coverage dates

These pages ask about the health insurance policy indicated on the previous page. They repeat for each person with a policy.

The “_____’s health insurance” page asks about the health insurance policy.
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Questions	How to answer
Does _____ pay a premium? (Optional)	Select Yes or No. If the applicant selects yes, the next two questions display.
How much is the premium?	Enter the premium amount.
How often does _____ pay it?	Select the frequency from the dropdown menu.
Does _____’s plan cover services from a doctor?	Select Yes or No.
Who else in your household is covered by this policy?	Select the member or members covered by this policy.

If the policy is held by someone outside of the household, a relationships page displays (Click to show)If the policy is held by someone outside of the household, a relationships page displays (Click to show)

The “Policy holder relationships” page asks about how the policy holder who is outside the home is related to household members.
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Questions	How to answer
Relationship to [Household Member Name]	This question repeats for each combination of people in the household. If the relationship has already been described, the answer prepopulates the next time it is asked.

The “Coverage periods” page asks about the coverage start date for the health care policy.
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Questions	How to answer
When did _____’s coverage begin?	Select the date from the calendar.
Will _____’s coverage end in the next 3 months?	Select Yes or No. If the applicant selects yes, the next question displays.
When will _____’s coverage end?	Select the date from the calendar.

The next page the applicant sees depends on the programs they are applying for.

If the application includes...	Continue to...
Health care	Step 3: Provide information on the insurance company
FoodShare only	Step 5: Additional health insurance

Step 3: Provide information on the insurance company

The “_____’s policy information” page asks about the insurance company and plan.

Questions	How to answer
What company offers [Policy holder name's] policy? (Optional)	Enter the name of the company.
Street address	Enter the full address of the company.
Health plan name (Optional)	Enter the health plan name.
Policy number (Optional)	Enter the policy number.
Group number (Optional)	Enter the group number.

The next page the applicant sees depends on the programs they are applying for.

If the application...	Continue to...
Includes BadgerCare Plus	Step 4: Provide additional information about the household member’s insurance source
Does not include BadgerCare Plus	Step 5: Additional health insurance

Step 4: Provide additional information about the household member’s insurance source

These pages ask for more information about how the household member has access to insurance, including if they will have continued access into the next year.

The “More about _____’s health insurance” page asks about the source of the health care policy and plan details.
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Questions	How to answer
Is _____’s insurance through their current job?	Select Yes or No. If the applicant selects yes, the next eight questions display.
Where does _____’s insurance come from?	Select the source from the dropdown menu.
Which employer provides this health insurance?	Select the employer that provides health insurance. The list shows employers previously entered by the applicant. Enter the name of the employer if not shown on the list.
Employer FEIN (Optional)	Enter the FEIN number of the employer.
Is _____’s insurance through a state employee benefit plan? (Optional)	Select Yes or No.
Employer address (Optional)	Enter the full address of the employer.
Employer phone number (Optional)	Enter the phone number of the employer.
Employer contact (Optional)	Enter the contact’s full name, phone number, and email address.
Does this employer offer a plan that meets the minimum standard value? (Optional)	Select Yes, No, or I don’t know. If the applicant selects yes, the next three questions display.
Minimum value plan name (Optional)	Enter the name of the plan.
Minimum value plan premium amount (Optional)	Enter the premium amount.
Minimum value plan premium frequency (Optional)	Select the frequency from the dropdown menu.

The “Next year’s coverage” page asks about potential changes to the health care policy in the next year.
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Questions	How to answer
Will [Employer Name] continue to offer [Policy holder name] health insurance next year? (Optional)	Select Yes, No, or I don’t know. If the applicant selects no, the next question displays.
When will [Policy holder name] lose access to this health insurance? (Optional)	Select the date from the calendar.
Will there be a change in premium cost next year? (Optional)	Select Yes, No, or I don’t know. If the applicant selects no, the next three questions display.
How much will [Policy holder name’s] premium cost next year? (Optional)	Enter the cost of the premium.
How often will [Policy holder name] pay this premium next year? (Optional)	Select the frequency from the dropdown menu.
When will the premium cost change? (Optional)	Select the date from the calendar.

The “Can anyone else get coverage?” page asks if anyone in the household could be covered by the health care policy but is currently not.
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Questions	How to answer
Is there anyone who could be covered by this policy, but isn’t? (Optional)	Select Yes or No. If the applicant selects yes, the next question displays.
Who could be covered?	Select the member or members that could be covered.

Step 5: Additional health insurance

This page asks the applicant if the policy holder has another health care policy.
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Questions	How to answer
Does [Policy holder name] have another health insurance policy that covers someone in your household? (Optional)	Select Yes, No, or I don’t know.

The next page the applicant sees depends on the programs they are applying for.

If the application...	Continue to...
Includes BadgerCare Plus	Step 6: Answer who has access to health care coverage
Does not include BadgerCare Plus	Step 8: Confirm information on the Summary page

Step 6: Answer who has access to health care coverage

The “Additional access to coverage” page asks who in the household has access to health care but is not currently enrolled.
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Questions	How to answer
Can anyone in your household get health insurance through their job, but they haven’t signed up for it? (Optional)	Select Yes or No. If the applicant selects yes, the next two questions display.
Who could get health insurance through their job, but currently isn’t?	Select the member or members that can get health insurance through their job but currently does not.
Could someone else get health insurance through their job that would cover you or the people in your household?	Select Yes or No.

The “People who could get insurance” page asks about how the policy holder who is outside the home is related to household members.
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Questions	How to answer
Name	Enter the full legal name of the individual who can cover people in the household.
Date of birth	Select the date from the calendar.
Is there another person who could get health insurance from their job that would cover someone in your home? (Optional)	Select Yes or No.

If more than one person in the household has a health insurance policy, the “Your household’s access to coverage” page displays. This page asks the applicant to select which household member’s health insurance information to enter first. The applicant is brought back to this screen until all the individuals who have health insurance are completed.
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Questions

How to answer

Choose who you’d like to tell us about first.

Select Start next to someone’s name to begin asking questions for that person.

The applicant is brought back to this screen until all the questions for individuals who have health insurance are completed.

Step 7: Provide information on the source of the available insurance

These pages ask for more information about how the household member has access to insurance, including if they will have continued access into the next year.

The “_____’s job that offers coverage” page asks about the source of the health care policy and plan details.

Questions	How to answer
Which employer provides this health insurance?	Select the employer that provides health insurance. The list shows employers previously entered by the applicant. Enter the name of the employer if not included on the list.
Employer FEIN (Optional)	Enter the FEIN number of the employer.
Is this insurance offered through a state employee benefit plan? (Optional)	Select Yes or No.
Employer address (Optional)	Enter the full address of the employer.
Employer phone number (Optional)	Enter the phone number of the employer.
Employer contact (Optional)	Enter the contact’s full name, phone number, and email address.
Does this employer offer a plan that meets the minimum standard value? (Optional)	Select Yes, No, or I don’t know. If the applicant selects yes, the next three questions display.
Minimum value plan name (Optional)	Enter the name of the plan.
Minimum value plan premium amount (Optional)	Enter the premium amount.
Minimum value plan premium frequency (Optional)	Select the frequency from the dropdown menu.

The “Next year’s access to coverage” page asks about potential changes to the household member’s health care coverage in the next year.
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Questions	How to answer
Will [Employer Name] continue to offer health insurance next year? (Optional)	Select Yes, No, or I don’t know. If the applicant selects no, the next question displays.
When will [Policy holder name] lose access to this health insurance? (Optional)	Select the date from the calendar.
Will there be a change in premium cost next year? (Optional)	This question displays if the applicant selects yes on the first question. Select Yes, No, or I don’t know. If the applicant selects yes, the next three questions display.
How much will this plan’s premium cost next year? (Optional)	Enter the cost of the plan for the next year.
How often would _____ have to pay this premium? (Optional)	Select the frequency of the payment from the dropdown menu.
When will the premium cost change? (Optional)	Select the date from the calendar.

The “Could anyone else get coverage?” page asks who in the home could be covered by the health insurance plan offered by this individual’s employer.
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Questions	How to answer
Is there anyone who could be covered by this policy, but isn’t? (Optional)	Select Yes or No. If the applicant selects yes, the next question displays.
Who could be covered?	Select the member or members who could be covered.

The “Is _____ waiting to enroll?” page asks if the individual plans to enroll in this health insurance plan or is in a waiting or probationary period.

Questions	How to answer
Is _____ in a waiting or probationary period?	Select Yes, No, or I don’t know. If the applicant selects yes, the next question displays.
When will the probationary period end?	Select the date from the calendar.
Does _____ plan to sign up for this health insurance in the next three months?	Select Yes, No, or I don’t know. If the applicant selects yes, the next question displays.
When does _____ plan to enroll?	Select the date from the calendar.

The “Additional health insurance” page asks if the household member has another health insurance policy through an employer that they could be on.
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Questions	How to answer
Does [Policy holder name] have access to another health insurance policy that covers someone in your household? (Optional)	Select Yes, No, or I don’t know.

Step 8: Confirm information on the Summary page

Once completed, a summary page displays. Here, the applicant can review the sections for accuracy before going to the next section.
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This page last updated in Release Number: 24-03
Release Date: 11/15/2024
Effective Date: 11/15/2024