Form CMS-10464 Agent-Broker Appendix A Screenshot

OMB Control Number: 0938-1204
Expiration Date: XX/XX/20XX
Agent/Broker Screenshots
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Login in to the CMS Enterprise Portal Login Page at https://portal.cms.gov

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Step #1: Select Your Application.

PRA Disclosure Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1204. CMS uses this
information collection to ensure agents/brokers possess the basic knowledge required to enroll individuals and Small Business Health Options Program
(SHOP) employers/employees through the Exchanges. The time required to complete this information collection is estimated to average less than
12 minutes for new agent/brokers issuers and 6 minutes for returning agent/brokers per response, including the time to complete the Federallyfacilitated Exchange (FFE) registration and training. This information collection, mandated by section 1312(e) of the Affordable Care Act and 45
C.F.R §155.220, requires agents/brokers must register for, and successfully complete, Exchange-specific training, which ensures
agents/brokers’ understanding of eligibility and enrollment requirements in Exchanges. Some information collected during the registration
process, including contact information for the agents/brokers, is published on Healthcare.gov to facilitate consumer contact with the
agents/brokers. This use of information is authorized by 45 C.F.R. §155.220(b), and has been reviewed by the CMS Office of General Counsel. All
other information collected will be kept private in accordance with regulations at 45 CFR 155.260. If you have comments concerning the accuracy
of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Mail Stop C4-26-05, Baltimore,
Maryland 21244-1850, and email Madeline Pelish at [email protected], Attention: Information Collections Clearance Officer.

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Portal new user account information Step #2: Register Your Information.

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Step #3: Create User ID, Password, and Security Question/Answer. New account creation of User ID
and password and security question/answer. An email will be sent to the address listed in the
account, notifying of successful account creation.

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Log in again to the CMS Enterprise Portal Login Page at https://portal.cms.gov

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Register a device for Multi-Factor Authentication (MFA). Select the down arrow icon next to
Username. Select My Profile. Select Manage MFA Devices in the left pane. Click on Register a
device.
Username

email@

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Select MFA Device drop-down list.
Username

email@

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Select Text Message (SMS). Enter Phone Number. Click Send MFA Code. FMA Code will be sent
directly to mobile device via a text message.
Username

email@

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Enter the security code sent to mobile device in Enter Code Received. Click Add Device.
Username

email@

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Confirmation message appears indicating the changes to the profile have been successfully
submitted.
Username

email@

Phone #

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Return to the My Portal page and click Add Application button.
Username

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Select the Federally Facilitated Marketplace (FFM)/Request for MLMS Training Access. Under Select
a Role, select the Agent Broker Training Access role.
Username

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Complete Identity Verification and select Launch.
Username

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Step #1: Identity Verification Overview and select Next.
Username

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Step #2: Accept Terms & Conditions by checking I agree to the Terms & Conditions and select Next.
Username

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Step #3: Enter Your Information by populating data, using residential information, and select Next.
Username

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Enter Reason for Request and select Submit. You will then be asked to log out.
Username

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