Revenue Cycle
and Billing

It’s Not too Late to Automate Your Ryan White Enrollments

by | Nov 22, 2021 | American Exchange News, Healthcare, Open Enrollment, Public Health, Ryan White HIV/AIDS

Your Ryan White clients are relying on you to enroll them in Affordable Care Act (ACA) health plans. Automating now will help you this year, in 2022, and beyond. 

Here are 5 reasons why you should automate your process for Ryan White clients today. 

  1. Assessing eligibility and applying tax credits takes more of your time. 

The American Rescue Plan (ARP) provides more financial assistance to:

  • Increase the number of people who are eligible for healthcare coverage through the marketplace (see figure below) 
  • Reduce premiums and subsidize more costs for existing enrollees
    • Households earning under 150% of the federal poverty level (FPL) can get $0 premium plans and subsidies to cover out-of-pocket costs. 
    • For those earning between 400%-600% of FPL are eligible for subsidies.

As a result, it will take more time to assess eligibility. You also have the added burden of ensuring you get the most tax credits and subsidies for eligible Ryan Whtie clients.

  1. Your enrollment volume will likely be higher. 

In the first week alone, 133,200 new enrollees signed up for marketplace plans (CMS). Because more people are eligible and more outreach efforts are underway to promote eligibility, your volumes could soar.  

  1. Your organization must implement a reconfirmation process. 

To reduce the administrative burden, the Health Resources and Services Administration (HRSA)’s HIV-AIDS Bureau eliminated the six-month client eligibility recertification requirement for Ryan Whtie programs (PCN 21-02). Now your organization is responsible to submit timely eligibility confirmation in accordance with your policies and procedures. 

  1. There is a special open enrollment period each month. 

Beginning in 2022, people with incomes up to 150% of the FPL are eligible for a special enrollment period each month. That’s $19,320 per year for a single person or $32,940 for a family of 3. 

  1. You will receive more calls and requests for help from clients. 

Two changes could significantly increase client questions and requests for help from your Ryan White program clients throughout the year. 

  • Premium tax credit repayment is required. During the pandemic, enrollees did not have to repay any excess 2020 premium tax credits, but the repayment requirement is back in force: 
    • Clients who under-estimated their 2022 incomes risk owing more taxes if they claim excess premium tax credits during the year. If your clients experience a significant change in their 2022 income after they’ve signed up, they should update their marketplace account as soon as possible to avoid receiving excess subsidies.
  • The No Surprises Act goes into effect on January 1, 2022. The Act requires health plans and insurers to provide an Advanced Explanation of Benefits (AEOB) for all scheduled services before delivering them. The AEOB is intended to prevent surprise billings by including a cost estimate for each service in easily understandable language. 

It’s not too Late to Automate

American Exchange can provide immediate help now, even while you’re knee deep in open enrollment. We can get you up and running on our automated system in as little as 1 day. If you want to customize our enrollment form, we can automate your process in 3-5 days.  

Our ACA-licensed insurance benefits managers provide Ryan White enrollment services for clients in 10 states. Services include:

  • Extended hours throughout the annual open enrollment period
  • Special open enrollment period enrollment services
  • Premium payment services
  • Re-confirmation of client eligibility
  • Year-round call center support to answer client questions, help them navigate the healthcare landscape, and assist with payment denials.

We have improved the efficiency of Ryan White enrollment programs, successfully increasing enrollments and maximizing tax credits.

Let our experts maximize tax credits for your Ryan White clients and make your process more efficient. Contact American Exchange today.

Call American Exchange today at 888.995.1674 or email us at