Basic info including the fields below.
Image AddedCurrent plan and past plans including start and end dates.
The screenshots below show:
Current plan (1)
Past Plans (2)
Start Dates (3)
End Dates (4)
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Tip: To verify the name of a plan, copy-paste the “Contract” and “PBP” numbers into a google search including the state. In the example above, if I want to see the name of the plan the customer I enter “h1019 102 florida” into a google search which reveals the customers plan is apparently the “2020 CareOne (HMO) - H1019-102-0 FL”
Image AddedPart A/B effective dates. Pay attention to whether the dates are the same or different as this provides clues regarding their situation. For example, if the part B date is later than part A, this can indicate the participant opted out of part B when initially eligible, possibly due to staying on an employer sponsored group plan.
Image AddedRecent enrollment periods (including LIS, MDE, and OEP) that have been used will be displayed under “Election Type Code Usage.” If MA-OEP or the Quarterly SEPs have been used, it will show you the code and the date it was used. This will indicate whether or not you can use these enrollment periods. If it appears as pictured below, then the beneficiary has not used OEP nor the quarterly SEPs.
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Extra help/LIS start/end dates and subsidy level. Usually it will include both the start and end date but sometimes the end date will not yet be entered for the time frame in which the LIS is currently active. The screenshot in the example below was captured on 5/26/21 and it already shows the end date of 12/31/21. Remember the Premium Subsidy Level indicates the Prescription Drug Premium Subsidy, NOT Part B Premium Subsidy.
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Right-Click Here and open in a new tab to view the 2022 LIS Table.