RFR Exhibit B - Reference Materials.xlsx
XLSX spreadsheet 2 MB Posted
- Solicitation number
- BD-25-1175-1175C-1175L-127564
- Issued by
- Massachusetts
About this file
This exhibit details member correspondence materials and communication protocols used by the Massachusetts Health Connector to notify subscribers of enrollment, billing, eligibility, and account management activities. The document provides a comprehensive reference guide of 61 distinct notice types and forms, plus email and SMS notification templates, organized by business purpose and triggered by specific enrollment or billing system events. The correspondence encompasses critical notifications including enrollment confirmations, premium billing statements, coverage termination notices, eligibility determinations, tax form distributions (1095-A), age-out warnings, payment reminders, hardship waiver decisions, and special enrollment period communications. Average monthly volumes range from single-digit notices for specialized communications to over 300,000 monthly notices for premium billing statements, with annualized volumes exceeding 3.7 million pieces in high-volume categories. The exhibit specifies trigger mechanisms for each notice type, identifies target member populations, and documents both English-language and translated versions (Spanish and Brazilian-Portuguese) for numerous communications. Email notifications are generated automatically when members elect paperless delivery, while SMS messages deliver time-sensitive enrollment and payment deadline reminders with multilingual support.
The correspondence framework indicates sophisticated segmentation by member status, including subsidized versus unsubsidized enrollees, newly enrolled versus existing subscribers, hard-delinquent versus soft-delinquent accounts, and age-based categories for dependent coverage changes. Marketing materials include standalone mailers addressing plan downgrades, open enrollment periods, and tax filing reminders. The system accommodates member-initiated requests for forms including appeal procedures, authorized representative designations, privacy policy copies, and affidavits for income or residency verification. Current volumes are noted as unavailable for certain emerging communication categories and forms triggered by contact center requests. The contract opportunity itself focuses on providing culturally and linguistically appropriate support for readability and usability improvements to these member communications, suggesting the Health Connector seeks to enhance accessibility and comprehension across its diverse member population.
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Notices
RFR EXHIBIT B - MEMBER CORRESPONDENCE
| Note: information in this attachment is not meant to be exhaustive but an illustration of the Health Connector's member communications by type; additional communications may be needed which are not included in this exhibit | |||||||
| # | Name | Business Purpose | Trigger | Attachments and/or inclusions | Population: who gets it? | Average Monthly Volume | Total in 12 month period |
| 1 | Quote for Enrollment Binder Payment | To inform potential subscriber of their premium payment amount due and due date in order to effectuate enrollment | This notice will be triggered the day after member plan was selected | No | Subscriber who has plan selected but has not paid or has not paid enough and has a premium more than $0 | 29,413 | 352,955 |
| 2 | Welcome Letter | To inform newly enrolled subscriber about coverage effective date, covered members, insurer name, plan name, and other pertinent information about their new enrollment | This notice will be triggered when a member is newly enrolled | No | Subscriber who is newly enrolled since the last run of the report | 17,303 | 207,632 |
| 3 | Monthly Premium Bill | To inform enrolled subscriber of the total amount due, due date for payment and other pertinent details about their enrollment, e.g. subsidy amounts, past payment history | This notice will be triggered when an enrolled member is billed on 1st of month | No | Enrolled subscribers with a premium amount due OR terminated subscribers getting their final bill OR terminated subscribers who can reinstate | 309,751 | 3,717,012 |
| 4 | Confirmation of Change from Electronic to Print | To inform that there has been a successful change in delivery preferences from receiving communications via email to mail. Use when user makes the change themselves and when change if made for them because emails cannot be delivered | This notice will be triggered when a member changes from electronic to print | No | Subscriber who had a change in delivery preferences from receiving communications via email to mail | 168 | 2,020 |
| 5 | Enrollment Termination | To inform that coverage has been terminated for reasons other than non-payment of premiums (such as voluntary termination) or changes in eligibility | This notice will be triggered when a member’s coverage is terminated for reasons other than non-payment of premiums (such as voluntary termination). | No | Members who have terminated for reasons other than NPP | 13,164 | 157,971 |
| 6 | Hardship Waiver Denial Notification | To inform that a hardship waiver application was denied | This notice will be triggered when a member is denied for hardship waiver | No | Members who submitted a hardship waiver application and have been denied | 40 | 479 |
| 7 | Hardship Waiver Approval Notification | To inform that a hardship waiver application was approved | This notice will be triggered when a member is approved for hardship waiver | No | Members who submitted a hardship waiver application and have been approved | 18 | 218 |
| 8 | Cancellation of an uneffectuated enrollment for NSF (NSF Cancel) | To inform that their binder payment was unsuccessful due to insufficient funds and, depending on date of NSF, subscriber still has time to pay to effectuate or their enrollment is canceled and they have to re-shop if they are still within their enrollment window | This notice will be triggered when a member binder payment is voided due to insufficient funds | No | Subscriber whose last binder payment was voided due to insufficient funds | 1,152 | 13,822 |
| 9 | Cancellation of an uneffectuated enrollment (Non Payment Cancelation) | To inform that deadline for payment has passed and sufficient payment was not received and enrollment cannot be effectuated. Informs subscriber that they can re-shop if they are still within their enrollment window | This notice will be triggered when a member fails to make sufficient payment to effectuate coverage in their selected plan | No | Subscriber who had plan selected and needed to make a payment to effectuate but did not make a full payment by the due date | 2,951 | 35,414 |
| 10 | Past Due Warning Notice | To inform subscriber enrolled in subsidized coverage that they are one month delinquent | When subsidized member becomes soft delinquent | No | Subsidized subscriber who is one month delinquent | 14,900 | 178,802 |
| 11 | Termination Warning Notice | To inform that an account has entered delinquency and a payment must be made to avoid termination for non-payment. Includes date to pay by and amount that needs to be paid | This notice will be triggered when a member becomes hard delinquent (if subsidized, missed second payment, if unsubsidized, missed single payment). | No | Member becomes hard delinquent (if subsidized, missed second payment, if unsubsidized, missed single payment). | 13,164 | 157,971 |
| 12 | Termination of Coverage for Non-Payment Notice (Non-Payment Termination) | To inform that coverage has been terminated for subsidized or unsubsidized subscribers. Includes coverage end date, reinstatement period and amount needed to pay to reinstate coverage. Includes payment coupon for reinstatement payment and due date for this payment | This notice will be triggered when a member’s coverage becomes terminated. | No | Subsidized and unsubsidized members who are terminated for non-payment | 5,463 | 65,554 |
| 13 | Age Out Warning Notice | To inform that a member is about to age out of their health and/or dental plan. Provides next steps member needs to take | This notice will be triggered 35 days prior to last day of coverage - the month prior to turning 26 | No | Head of household with dependents of members turning 26 years old | 60 | 719 |
| 14 | Catastrophic Age Out Warning Notice | To inform that a member is about to age out of their catastrophic health plan because they are turning 30 unless they have a waiver for coverage to continue. Provides next steps member needs to take | This notice will be triggered 35 days prior to last day of coverage which is December 31 | No | Subscriber with dependent turning 30 years old enrolled in a catastrophic plan and that subscriber does not have a waiver for coverage to continue | N/A | 51 |
| 15 | Age Out Termination Notice | To inform that a member has aged out of their health and/or dental plan and his/her coverage in that plan has ended. Provides next steps member needs to take | This notice is triggered when a member turns 26 years old and is terminated from the subscribers health/dental plan | No | Head of household with dependents of members turning 26 years old | 40 | 484 |
| 16 | Catastrophic Age Out Termination Notice | To inform that a member has aged out of their catastrophic health and/or dental plan and his/her coverage in that plan has ended. Provides next steps member needs to take | This notice is sent in December for all members who have turned 30 and aged out of their catastrophic health/dental plan | No | Subscriber with dependent turning 30 years old enrolled in a catastrophic plan, unless they have a waiver for coverage to continue | N/A | 26 |
| 17 | Increase in account balance for subscriber who is already termed (Adjusted Termination Warning) | To inform a subscriber whose enrollment has ended but there was activity or enrollment change on the account and as a result account is no longer paid for the enrollment that they had previously | This notice is triggered for terminated members who have activity after the termination date, and that activity increases the balance due making the member no longer paid through the termination date that was previously stated | No | A terminated subscriber who has activity after the end date, which increases the balance due on account | 8 | 98 |
| 18 | 1095A Form | To provide federally required information to any person who was enrolled in non-group health insurance coverage during the prior tax year, excluding Catastrophic Plans. This information is needed for tax filing | This notice will be triggered when the IRS Detail files are sent to notice creation queue after the vendor receives IRS Acceptance | Cover Letter / FAQ | Any enrollee who was enrolled in a Qualified Health Plan (QHP) for at least 1 day of 1 month at any time during the calendar year, excluding catastrophic enrollees | 22,260 | 267,121 |
| 19 | Ad-hoc Mail | To be used for any reason not already covered by other notices; to inform members of an event, an action they need to take or an issue | This notice will be triggered on demand when the Health Connector needs to outreach to a certain population of members to inform of an event, a needed action or an issue; this volume could be significant depending on the event | No | Members impacted by issues that require Service Recovery | 5,887 | 70,644 |
| 20 | Bank Payment Canceled (Void Payment) | To inform Members that their payment voided and was thus unsuccessful | This notice is triggered when there is a change to the Member's financial status due to a voided payment by the Member's bank or financial institution | No | A subsidized member whose payment was voided and thus unsuccessful processed | 5,081 | 60,977 |
| 21 | Change of Address - Request to Update | To inform household(s) that mail was returned with a new forwarding address in Massachusetts. The new address was used to update the mailing address for the household. It informs the household that if the residential address has changed as well, it should be updated as soon as possible | This notice is triggered when a new forwarding address is received from the USPS for a Member. | No | Head of Household who returned a new forwarding address in Massachusetts | 3,348 | 40,173 |
| 22 | Resent Mailer | To provide a copy of a Member requested notice | This notice is triggered when a Member calls customer service and requests a copy of a notice | Member requesting a copy of a notice | 1,425 | 17,096 | |
| 23 | 1095A Correction | To provide federally required information to any person that previously received a 1095-A form containing one or more errors. This information is needed for tax filing | This notice will be triggered when the IRS Detail files are sent to notice creation queue after the vendor receives IRS Acceptance | Cover Letter / FAQ | Any person that previously received a 1095-A form containing one or more errors. | 280 | 3,355 |
| 24 | 1095A Void | To provide federally required information to any person who previously received a 1095-A Form that was issued in error. This information is needed for tax filing | |||||
| This notice will be triggered when the IRS Detail files are sent to notice creation queue after the vendor receives IRS Acceptance | Cover Letter / FAQ | Any person who previously received a 1095-A Form that was issued in error. | 16 | 193 | |||
| 25 | Age Out Pediatric Dental | To inform the head of household with dependents turning 19 years old that they have aged out of their pediatric dental plan | This notice is triggered when a dependent has aged out of a pediatric Dental plan | No | Head of household with dependents of members turning 19 years old | 1 | 6 |
| 26 | Carrier Proof of Residency (200) | To verify a Member's residence in Massachusetts. | Notice is triggered if Member generates a number of out of state claims | No | Subscribers flagged as potentially residing out of Massachusetts | 1 | 10 |
| 27 | Identity Proof Confirmed (202) | To inform account holder(s) that proof of Identity has been received and verified, and they may now access their online account to complete their eligibility application | Notice is triggered when proof of identity has been received and verified | No | Member who has provided acceptable proof of identity and is now verified | 4,501 | 54,012 |
| 28 | Request for Information Unacceptable Proof (204) | To inform Primary Recipient that the documents they sent to prove their ability to qualify for coverage cannot be used and to send new documents from the list of acceptable documents displayed at the end of the notice | This notice is triggered when a member does not provide proof of their ability to qualify for health or dental coverage | No | Primary Recipient that did not provide acceptable documentation to prove that they qualify for coverage | 1 | 10 |
| 29 | CCA Closed Enrollment Warning Notice | To inform Head of Household that the Special Enrollment Period Request For Information for their application is due in (X) number of days (X is configurable; Default is 35 days or less) | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | Current volume not available | Current volume not available |
| 30 | CCA Insufficient Document Notice | To inform the Primary Recipient when the documents provided by the member against Eligibility Request for Information (RFI), Special Enrollment Period Request for Information (SEP RFI) or Manual ID Proofing do not get verified due to the necessary information missing. Member will receive an Insufficient Document Notice explaining specific document rejection reasons and enlisting all acceptable documents | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 5,993 | 71,914 |
| 31 | CCA Periodic Data Match (PDM) Notice | To inform individuals that the Health Connector has received new information about the members in their household and based on the new information there will be a change in their eligibility | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 93 | 1,118 |
| 32 | CCA Special Enrollment Period (SEP) Enrollment Termination Notice | To inform an individual that their Special Enrollment Period enrollment is terminated due to Special Enrollment Request for Information Timeclock expiry determination | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | Current volume not available | Current volume not available |
| 33 | CCA Special Enrollment Period (SEP) Request for Information (RFI) Insufficient Document Notice | To inform Primary Recipient when the documents provided by the member against Special Enrollment Period Request for Information do not get verified due to the necessary information missing. Member will receive a CCA Special Enrollment Period (SEP) Request For Information (RFI) Insufficient Document Notice explaining specific document rejection reasons and enlisting all acceptable documents | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 212 | 2,538 |
| 34 | Closed Enrollment Verification Confirmation (CE-VERCONF) | To inform Head of Household (HOH) that the Special Enrollment Period Request for Information (SEP RFI) for the application has been verified | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 550 | 6,597 |
| 35 | Documents needed reminder (RFI_REM) | To inform Head of Household that the due date on the active eligibility Request For Information (RFI) is approaching, and document needs to be provided for the same | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 6,718 | 80,612 |
| 36 | Eligibility Denial (ELDEN01) | To inform applicant that they were not approved for health benefits through the Health Connector and includes the reason(s) why the individual was not approved | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 124,142 | 1,489,700 |
| 37 | Eligibility Termination (ELTERM01) | To inform a member that they no longer qualify for coverage. The notice outlines the following information specific to the member: coverage type that is ending, coverage end date, and the reason the member no longer qualifies for this coverage type | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 2,110 | 25,314 |
| 38 | Eligibility Approval (ELAPR01) | To inform individuals in a Household that they have been approved or provisionally approved for a Health Connector Plan benefits through the Massachusetts Health Connector | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 158,334 | 1,900,009 |
| 39 | Final Renewal (AUTO_REN) | To inform individuals in a Household whose medical plan will be auto renewed during the annual auto renewal processing. The notice will inform Household members about the medical plan they will be auto enrolled in for the upcoming year and will specify the actions that members can take going forward with an explanation of the options available | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 25,245 | 302,938 |
| 40 | Preliminary Eligibility Determination (ELG_REN) | To inform individuals in an impacted CCA and mixed household (as defined by the renewal requirements) of their prospective eligibility for the upcoming benefit year. The notice provides a 30 day timeframe to come back into the system and make any changes to their eligibility application if they disagree with the information in the notice or have any updates to report | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 19,830 | 237,960 |
| 41 | Request for Identity Proof (RIDP01) | To inform the Account holder that their identity could not be verified electronically during the application process. All applicants who apply via online will need to have their identity authenticated. If a member fails Identity Proofing, they will not be able to complete their application until they have sent in acceptable documentation and their identity has been manually authenticated | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 10,974 | 131,691 |
| 42 | Request for Information (Proof Needed) (ELRFI01) | To inform households that are eligible for CCA benefits at the time of determination and ask that they submit documentation to verify eligibility information | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 15,427 | 185,121 |
| 43 | Special Enrollment Period Decision (SEP-DEC) | To inform individuals whether they qualify/do not qualify to enroll in a new Health Connector Plan through the Massachusetts Health Connector as a result of an Special Enrollment Period (SEP) determination | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 7,505 | 90,057 |
| 44 | Premium Increase Reminder Notice (CCA_PRM_IN) | To inform Head of Household (HOH) that the monthly premiums of one or more shopping groups in their household has increased | This notice is triggered by Optum. The EPB vendor shall proceed with notice processing once the XML is received from Optum | No | Head of Household / ARD / PSI / Navigator of Head of Household | 4,685 | 56,214 |
| 45 | Appeals / Hearing Request Form | To file an appeal (request a hearing) if the member disagrees with an action that the Massachusetts Health Connector took on their behalf | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting a hearing to appeal a decision/action taken on their behalf by the Massachusetts Health Connector | Current volume not available | Current volume not available |
| 46 | Authorized Representative Designation Form | To allow a Member to designate an authorized representative to act on their behalf | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting to designate an authorized representative to act on their behalf | Current volume not available | Current volume not available |
| 47 | Privacy Policy | To inform a Member about how their information may be used and disclosed and how they can get access to the this information | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting a copy of the Massachusetts Health Connector Privacy Act | Current volume not available | Current volume not available |
| 48 | Permission to Share Information (PSI) Form | To allow a Member to designate who they want their information to be shared with | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting to share their information with another person or organization | Current volume not available | Current volume not available |
| 49 | Application for Health and Dental Insurance Coverage (No Financial Assistance) | To allow a Member to apply for coverage without financial assistance | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting a paper application to enroll in coverage without financial assistance | Current volume not available | Current volume not available |
| 50 | Massachusetts Application for Health and Dental Coverage and Help Paying Costs | To allow a Member to apply for coverage with financial assistance | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting a paper application to enroll in coverage with financial assistance | Current volume not available | Current volume not available |
| 51 | Voter Registration Form | To allow a Member to pre-register or register to vote in Massachusetts | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member requesting a Voter Registration form to pre-register/register to vote | Current volume not available | Current volume not available |
| 52 | Affidavit to Verify Incarceration Status | To allow a Member to confirm their incarceration status | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who needs to verify their Incarceration Status | Current volume not available | Current volume not available |
| 53 | Affidavit to Verify Massachusetts Residency | To allow a Member to confirm their Massachusetts residency | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who needs to verify their Massachusetts Residency | Current volume not available | Current volume not available |
| 54 | Affidavit to Verify Zero Income | To allow a Member to verify their zero Income | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who needs to verify their Zero Income | Current volume not available | Current volume not available |
| 55 | Terms and Conditions of Enrollment Agreement | To inform members of the Enrollment Agreement Terms and Conditions | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who requests a copy of the Terms and Conditions of Enrollment Agreement | Current volume not available | Current volume not available |
| 56 | Rights and Responsibilities | To inform a member of their Rights and Responsibilities | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who requests a copy of the Rights and Responsibilities | Current volume not available | Current volume not available |
| 57 | Filing an application for a Premium Waiver or Reduction | To allow a member to file for a premium waiver or reduction if they are experiencing extreme financial hardship | This form is triggered by the Contact Center. The EPB vendor shall proceed with notice processing once the request is received | No | Member who requests application for a premium waiver or reduction due to financial hardship | Current volume not available | Current volume not available |
| 58 | Simple Sign-up_Not Found Mailer | To inform member that we are not able to identify which type of coverage they qualify for based on the information we have. | This notice will is triggered on demand when the Health Connector sends the DOR file to the EPB vendor for notice creation. | No | Member who indicated they are interested in applying for health insurance through the Health Connector on their State Tax Return | Current volume not available | Current volume not available |
| 59 | Simple Sign-up_Unsubsidized Member | To inform member that they do not appear to qualify for help paying for their coverage based on the information we have. | This notice will is triggered on demand when the Health Connector sends the DOR file to the EPB vendor for notice creation. | No | Member who indicated they are interested in applying for health insurance through the Health Connector on their State Tax Return | Current volume not available | Current volume not available |
| 60 | Simple Sign-up_APTC Member | To inform member that they appear to qualify for Advanced Premium Tax Credits to help pay for their coverage. | This notice will is triggered on demand when the Health Connector sends the DOR file to the EPB vendor for notice creation. | No | Member who indicated they are interested in applying for health insurance through the Health Connector on their State Tax Return | Current volume not available | Current volume not available |
| 61 | Simple Sign-up_ConnectorCare Member | To inform member that they appear to qualify for ConnectorCare Plans. | This notice will is triggered on demand when the Health Connector sends the DOR file to the EPB vendor for notice creation. | No | Member who indicated they are interested in applying for health insurance through the Health Connector on their State Tax Return | Current volume not available | Current volume not available |
Marketing Mailer Samples
| What to Expect_Standalone Marketing Mailer Sample | ||
| Front | Back | |
| Downgrade_Standalone Marketing Mailer Sample | ||
| Front | Back | |
| Open Enrollment postcard to EUN _Standalone Marketing Mailer Sample | ||
| Front | Back | |
| Plan Type 1 & 2A Tax Filing Reminder _Standalone Marketing Mailer Sample | ||
| Front | Back |
Emails
| RFR EXHIBIT B - MEMBER CORRESPONDENCE | |||||
| NOTIFICATION TYPE | Spanish Version Exists | Brazilian-Portuguese Version Exists | Triggered From | TIMING | TRIGGER |
| AutopayCancelBySystemConfirmation | Yes | Yes | Enrollment and Billing System | Daily | When the system cancels a member's autopay, because when attempting to draw the payment there are insufficient funds or incorrect bank account information provided |
| AutoPayDeletionSuccess | Yes | Yes | Enrollment and Billing System | Daily | When the Member goes on the Member portal and cancels their recurring autopay setup |
| AutoPayReminder | Yes | Yes | Enrollment and Billing System | Daily | Sent to the Member 5 days prior to their scheduled autopay date |
| AutoPaySetupConfirmation | Yes | Yes | Enrollment and Billing System | Daily | Member signs up for recurring autopay on the Mmember portal |
| ConfirmEmail | Yes | Yes | Enrollment and Billing System | Daily | Member initiated by going on the Portal to sign up for paperless. Member must click link in email in order to finalize paperless setup |
| IndividualInvoice | No | Yes | Enrollment and Billing System | Daily | When a new paperless invoice folder is created, after PDF generation, this email is triggered rather than exporting the PDF for mailing |
| LatePayment | Yes | Yes | Enrollment and Billing System | Monthly | When a Member has a Past Due or Termination Warning notice created for them, due to them being overdue on their payments |
| NoticeAvailability | Yes | Yes | Enrollment and Billing System | Daily | When a new paperless notice folder is created, after PDF generation, this email is triggered rather than exporting the PDF for mailing |
| NotificationPreferencesUpdated | Yes | Yes | Enrollment and Billing System | Daily | Informs the Member that they will now receive paperless communication. Triggered after the Member confirms their email through the ConfirmEmail message |
| PaymentSuccess | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member makes a payment on the Member portal |
| ReturnPayment | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member's payment is voided due to either incorrect/missing information or insufficient funds in the Member's account |
| ScheduledPaymentCancellation | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member cancels their future scheduled payment |
| ScheduledPaymentCreationSuccess | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member successfully schedules a payment |
| ScheduledPaymentEditSuccess | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member successfully edits their scheduled payment (Updating the payment date, payment amount, etc.) |
| UndeliverableMail | No | No | Fulfillment/USPS Reporting | Daily | Sent when EPB system receives notification that a notice/invoice was undeliverable. The email is sent to the Member informing them that their notice could not be delivered and requests that the member update their mailing address in the member portal |
| DeactivateAutopay | Yes | Yes | Enrollment and Billing System | Daily | Sent when a Member's autopay has been deactivated after 90 days of the subscriber's account being inactive |
| 1095A | Yes | No | Enrollment and Billing System | Sent when a new tax form is available | |
| PaymentFailure | Yes | Yes | Enrollment and Billing System | Sent when a payment is unable to be processed successfully | |
| PaymentReminder | Yes | Yes | Enrollment and Billing System | Sent when a member has an upcoming premium amount due |
SMS
| RFR EXHIBIT B - MEMBER CORRESPONDENCE | |||
| Message Name | English Version Exits | Spanish Version Exists | Brazilian-Portuguese Version Exists |
| Deadline Reminder | Act now! To start an enrollment in a Health Connector plan, shop, and pay by the 23rd for coverage to begin on the 1st of next month. Log in at mahix.org/individual to finish enrolling or call 877-623-6765. Msg & data rates may apply. Reply HELP for help, STOP to cancel. | ¡Actúa ahora! Para iniciar una inscripción en un plan Health Connector, compre y pague antes del 23 del mes para que la cobertura comience a partir del primero del mes siguiente. Inicie sesión en mahix.org/individual para finalizar la inscripción o llame al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| Downgrade Text | If you are a Health Connector member experiencing higher premiums in 2025, update your application to make sure your premiums are correct. Log in to mahix.org/individual or call 877-623-6765. Msg & data rates may apply. Reply HELP for assistance, STOP to cancel. | Si es miembro de Health Connector y tendrá primas más altas en 2025, actualice su solicitud para asegurarse de que sus primas sean correctas. Inicie sesión en mahix.org/individual o llame al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| Binder payment Missed | If you are a Health Connector member and missed a payment deadline, you still have time to get into coverage! Enroll by the 23rd to start coverage next month. Log in to mahix.org/individual or call 877-623-6765. Msg & data rates may apply. Reply HELP for assistance, STOP to cancel. | Si es miembro de Health Connector y no cumplió con la fecha límite de pago, ¡aún tiene tiempo para obtener cobertura! Inscríbase antes del 23 del mes para comenzar la cobertura a partir del primero del mes siguiente. Inicie sesión en mahix.org/individual o llame al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| MH Redet - Transition to CCA | People who lost MassHealth and want a Health Connector plan must enroll by the 23rd for coverage to begin on the 1st of next month. Log in to mahix.org/individual or call 877-623-6765. Msg & data rates may apply. Reply HELP for help, STOP to cancel. | Las personas que perdieron MassHealth y quieren un plan Health Connector deben inscribirse antes del 23 del mes para que la cobertura comience a partir del primero del mes siguiente. Inicie sesión en mahix.org/individual o llame al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| Premium Change | Avoid high premiums in 2025 and shop for a Health Connector plan by logging in at mahix.org/individual or call 877-623-6765. Msg & data rates may apply. Reply HELP for help, STOP to cancel. | Evite primas altas en 2025 y compre un plan Health Connector iniciando sesión en mahix.org/individual o llamando al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| Carrier Change | To confirm 2025 Health Connector plan enrollment and complete payment for coverage to start, members should log in at mahix.org/individual or call 877-623-6765. Msg & data rates may apply. Reply HELP for help, STOP to cancel. | Para confirmar la inscripción en un plan de Health Connector en 2025 y completar el pago para que comience la cobertura, los miembros deben iniciar sesión en mahix.org/individual o llamar al 877-623-6765. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| Opt-In | The Health Connector can now send you text messages with account updates. To opt-in please reply "Yes". Texts are subject to our Terms of Use and Privacy Policy. Please review them at https://www.mahealthconnector.org/site-policies/terms-of-use. Msg & data rates may apply. Reply HELP for help, STOP to cancel. | El Health Connector ahora puede enviarle mensajes de texto con actualizaciones de su cuenta. Para participar, responda "Sí". Los textos están sujetos a nuestros Términos de uso y Política de privacidad. Revíselos en https://www.mahealthconnector.org/site-policies/terms-of-use. Se pueden aplicar tarifas de mensajes y datos. Responda AYUDA para obtener ayuda, ALTO para cancelar. | N/A |
| RFI | The Health Connector recently sent you a Request for Information notice to confirm information on your application. We need this information to continue coverage. Be sure to reply by the due date or you may lose your coverage. Log in to mahix.org/individual or call 877-623-6765 to confirm what is needed | El Health Connector le envió recientemente un aviso de Solicitud de información para confirmar la información de su solicitud. Necesitamos esta información para continuar con la cobertura. Asegúrese de responder antes de la fecha límite o podría perder su cobertura. Inicie sesión en mahix.org/individual o llame al 877-623-6765 para confirmar lo que se necesita | N/A |
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