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To seamlessly accommodate the millions of Americans switching their health coverage during Open Enrollment, health plans should prepare to facilitate both passive and active renewals through automated processes and custom rule configurations.

How to Connect with Passive Renewal Candidates

In mid-October, health plans on marketplace platforms receive Batch Auto-Re-enrollment (BAR) files from CMS and state-based exchanges. The details within these files outline specifics for any enrolled members, allowing insurers to engage current customers with auto-renewal options.

These BAR files act as precursor for health plans to ensure that their infrastructure and enrollment processes are ready to continue covering these existing members automatically. Health plans must have a plan in place that effectively transitions existing members to the same coverage for the upcoming year.

However, BAR files will only be provided for those individuals and families that your health plan covers through the Marketplace or the state-based exchanges. Any enrollees currently off-platform will require an internal auto-renewal process to gather relevant data and effect those re-enrollments. Softheon offers services to help with collecting and acting on those off-platform data captures if you have not yet done so.

What to Expect and Prepare for with Active Renewals

Active renewals center around candidates who enrolled in “Plan A” for 2021 and want to instead enroll in a “Plan B” that you offer for 2022. Transactional enrollments will trigger a cancelation of the current policy and engage a new plan. You’ll want to design automated processes customized for your specific business needs for this transition of plans, including any new binder payments you might make effective for the new year’s coverage.