CMS-10797 iClaim

iClaim - Special Enrollment Period
BNI006 – Special Enrollment Period (Initial View)

Note: When the user visit BNI006 for first time and have not answered anything, the dropdown is not presented on the
page.

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BNI006 – Special Enrollment Period (More Info Link)
To see more detailed information the user is encouraged to click on the More Info link.

When the user clicks on the More Info link, they are presented with a pop-up window that shows detailed information
about the SEP types.

iClaim - Special Enrollment Period
Full view of More Info page:

iClaim - Special Enrollment Period
Full view of Other SEPs Privacy Act Statement:

iClaim - Special Enrollment Period
Full view of SEP Paperwork Reduction Act:

iClaim - Special Enrollment Period
BNI006 – Special Enrollment Period - Dropdown View
If the user answers Yes to “Does one of the listed Special Enrollment types apply to you?” the dropdown will appear.
When user expands the dropdown, it will show the list of SEP types they can select from within iClaim.

iClaim - Special Enrollment Period
OVS001 - Overall Summary – Special Enrollment Period Information

iClaim - Special Enrollment Period
OVS001 - Overall Summary – Special Enrollment Period Information - Electronic Signature Agreement

iClaim - Special Enrollment Period
REC001 - Receipt – Special Enrollment Period Information