Certified Application Counselors In Ohio

Nita Carter, Health Equity DirectorUHCAN Ohio

Recruiting Certified Application Counselors:What will be covered:

• Overview of Navigation in Ohio• Recruiting Certified Application Counselor

Organizations• Providing Technical Assistance• Legislative Advocacy• Engaging Faith and Community Based Programs in

Navigation• Future Trends

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Ohio’s Navigation System:• Navigators• Federally Qualified Health Centers• Certified Application Counselors• Cognasante• SAR• Agents and Brokers• ONCE• Regional Enrollment Assistor Tables

Recruiting Certified Application Counselor Organizations:• Identified Programs working in communities who

should be a part of the Navigation System

Used the organizations we worked with around CTG grants and the UHCAN Ohio Health Equity Committee to help us Identify programs

• Convened regular statewide conference calls to educate them on navigation under the ACA and prepare them for the navigation grants coming out.

• Held CAC orientations in 4 Cities across the state.• Convened follow-up calls for those organizations

who decided to become CAC’s.

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Providing Technical Assistance to Faith and Community Based Organizations:

• Regular updates on navigation process, what is working and what is not;

• Provide information from the various networks and offices, (ONCE, regional assistor tables, Community Catalyst, In the Loop and CMS);

• Assist with filling out CAC Applications, setting up their programs and provide sample documents and;

• Available by phone to answer questions and participate by phone or in person for first enrollment.

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Legislative Advocacy:Engaged faith and community based programs in advocating against HB3 and SB9.• Developed testimony, draft language and

participated in legislative stakeholder meetings.

Signed onto a letter asking Ohio’s Department of

Insurance to become a Consumer Assistance State

Partnership Exchange.

Developed recommendations for effective navigation in

communities of color.

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How Are they Involved in Navigation:

Participated in the joint navigator application of the Ohio

Association of Food Bank;.

Became Certified Application Counselors and;

Working with the Navigator Organizations in their area to

host events and refer people they work with to enrollment

Assistors.

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Future Plans/Trends:Building the infrastructure among community and faith

based organizations to:

• Become a part of the feedback loop on what is working and what is not with respect to enrollment, linking to care and new models of care.

• Participate in future ACA implementation planning and delivery system reform .

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Sample Training Materials

• Certified Application Counselor • Sample Training Materials.

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Overview

• Basics of the ACA• Medicaid Expansion• Health Insurance Marketplace• Navigators• Mandate

• What You Can Do to Help Your Members/Clients Now

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The Affordable Care Act Expands Access to Coverage

Medicaid Expansion

• All adults up to 138% of the Federal Poverty Level ($15,856 per year for household of one) are eligible if Ohio accepts the expansion of Medicaid

Private insurance through the Marketplace (Exchange)

• Offers choices of private insurance plans (Qualified Health Plans – QHPs) with financial help available to those who qualify.

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Health Insurance Marketplace in 2014

Congress will get its coverage through the same Marketplaces.

Interesting Fact about the Marketplace:

Creates one-stop shop for easy comparison of coverage options

Gives consumers more choice and control

Offers coverage options through a website and helpline

Subsidies for individuals and tax credits for small businesses are available to make it more affordable

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What A Household of One Can Expect to Pay with a Tax Subsidy

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Navigators – How to Get Help with the Marketplace

The Marketplace is required to create a navigator program

to:• Inform people about their new insurance options• Help people enroll in their plan of choice• Help people keep their coverage (stay enrolled)

Insurance brokers and agents can also help.

The Navigator does not choose a plan or

advise which plan to choose.

Navigators may not be compensated by insurers to enroll people in

the Marketplace, and Ohio’s HB 3 is disqualifying providers

reimbursed by insurers for medical services provided.

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Navigators Serving Ohio

• Helping Hands Community Outreach Center (Dayton) • Call 937-268-6066 • Anticipated grant amount: $230,920

• Neighborhood Health Association (Toledo) • Call 419- 720-7883• Anticipated grant amount: $684,630

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Navigators Serving Ohio

• Ohio Association of Foodbanks (Serving most parts of Ohio) • Call 614 221-4336• Anticipated grant amount: $1,958,961

• Clermont Recovery Ctr, Inc. (Clermont, Brown and Adams Counties)• Call Tammy Altman at 513- 735-8100• Anticipated grant amount: $44,938

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Navigator Collaborative of the Ohio Association of Food Banks

• Ohio Association of Foodbanks, All 88 Counties

• Access Health Mahoning Valley (AHMV), Mahoning and Trumbull Counties

• Asian Services in Action, Inc. (ASIA), Cuyahoga, Franklin, Hamilton, Lucas, Montgomery,

and Summit Counties

• Carmella Rose Health Foundation (CRHF), Cuyahoga County

• Cuyahoga Health Access Partnership (CHAP), Cuyahoga County

• Community Action Committee of Pike County (CACPC), Jackson, Pike, and Scioto

Counties

• Disability Rights Ohio (DRO), All 88 Counties

• Health Care Access Now (HCAN), Adams, Brown, Butler, Clermont, Hamilton, and

Highland Counties

• Heart of Ohio Family Health Center (HOFHC), Franklin County

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Navigator Collaborative of the Ohio Association of Food Banks

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• Hospital Council of Northwest Ohio (HCNO), Allen, Ashland, Auglaize, Crawford, Defiance, Erie, Fulton, Hancock, Hardin, Henry, Huron, Lucas, Mercer, Ottawa, Paulding, Putnam, Richland, Sandusky, Seneca, VanWert, Williams, Woods, and Wyandot Counties

• Ohio Association of Free Clinics (OAFC), 40 Counties Across Ohio

• Ohio Department of Health (ODH), All 88 Counties

• United Way of Greater Cleveland 2-1-1 (UWGC), Ashland, Cuyahoga, Geauga, Holmes, Medina, Portage, and Wayne Counties

• The Community Action Program Corporation of Washington Morgan Counties (WMCAP), Morgan and Washington Counties

• Western Reserve Area Agency on Aging (WRAAA), Cuyahoga, Geauga, Lake, Lorain, and Medina Counties

How to Help Your Members/Clients• Become a Certified Application Counselor

Organization

• Get the word out about Enrollment• Encourage them to visit healthcare.gov and sign up for

email updates• Include articles in your newsletter• Print materials/handouts• Invite Enroll America to your meetings• Schedule a presentation with UHCAN Ohio

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Become a Certified Application Counselor (CAC) • CACs are trained by the federal government to help

people understand their choices under the Affordable Care Act. The training is free.

• CACs are usually people working in agencies or organizations that help people secure health care or other benefits.

• CACs are not paid by the federal government to do their work, but some private money may be available.

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How to Become A CAC1. Find out what is required of a CAC. http://marketplace.cms.gov/help-us/cac.html

2.Fill out an application on-line found at  http://marketplace.cms.gov/help-us/cac-apply.html(Application takes about 15 minutes to fill out)

3. Someone from Center on Consumer Information and Insurance Oversight (CCIIO) will contact those organizations who appear to have the qualifications to get more detail.

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How to Become a CAC (continued)An organization that wants to be a CAC should:

1. Already be helping people to secure assistance of some kind.

2. Have a system for protecting confidential client data

3. Screen employees and volunteers who help clients and handle sensitive information

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Becoming a CAC (continued)4. Be aware of any relationships with insurance

companies or others that could pose a conflict of interest and be prepared to discuss with CCIIO.

5. Be prepared to enter into a written agreement with CCIIO.

6. Identify who in your organization will be trained to be a CAC.

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What are the benefits to becoming a designated CAC organization?

A: CAC designated organizations will benefit by

receiving the Marketplace’s training and being able to

represent themselves to consumers as being certified

by their state’s Marketplace to provide application and

enrollment assistance.

In addition, becoming a CAC will build the capacity of

the organization’s staff and volunteers which will build

their own marketability.

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Training To Be a CACHow will training work?A: Because the CAC training is web-based, it can be completed at any

time. Individual CACs must complete the training before being certified

by their designated CAC organization.

How many hours will the CAC training be? A: Approximately 5 hours.

 

Do all of our employees/volunteers need to take the

training or just those it wants to certify to be CACs? A: Only those who will be certified to be CACs are required to take and

pass the CAC training.

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Screening to Be a CAC

What does it mean to screen staff and volunteers

who would become individual CACs?

A: Screening could involve background checks, calling past employers

for references, checking government-issued identification, or other tools

that will tell whether the organization can trust its staff and volunteers to

handle any private consumer information responsibly and securely, to

adhere to all CAC program requirements and standards, and to act in

the best interest of the consumers they assist.

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Screening to be a CAC

What level of health care knowledge should an

individual already have to become a CAC?

A: There is no minimum level of knowledge required for an individual to

be certified as a CAC, other than completing the required CAC

training. The training will teach each individual CAC everything he or

she needs to know to help consumers apply for and enroll in coverage.

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Role of CAC

Can a CAC actually help an individual compare health

plans and assist the individual in choosing a health

plan?

A: Yes, those are required duties of a CAC. But remember that a CAC

cannot actually choose a plan or enroll someone in a plan. A CAC may

only assist with plan selection and enrollment, and must provide this

assistance in the consumer’s best interest.

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Role of CACAre there quotas for how many consumers each CAC

or designated CAC organization must assist?

A: No. There are no requirements regarding the minimum number of

consumers a designated CAC organization or each CAC must assist.

About how long on average will it take a CAC to walk a

consumer through enrollment?

A: It will vary depending on the consumer’s needs. We estimate that it

will take about one hour to walk a typical client through the entire

process.

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Difference Between and CAC and a Navigator?

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Navigators:

• Funded through grants through the Marketplace

• Strict conflict of interest requirements

• Required to conduct outreach and education

CACs:

• Not funded through Marketplace but may obtain finding from other sources

• Conflict of interest disclosure requirements but won't prevent from becoming a CAC

• Not required to conduct outreach and education

Difference Between CAC and Broker?

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A: Unlike agents and brokers, CACs cannot charge

consumers for their assistance and are not paid by health

insurers to sell insurance. Agents and brokers are licensed

by their state to sell insurance. CACs do not sell insurance,

nor will they be enrolling individuals in health coverage,

including QHPs offered through the Marketplace.

How to Become a CAC (continued)Think through how you plan to help people.

• Will you establish an appointment system?

• Will you set up certain days of the week that you have “first come, first serve” clinics?

• Will you partner with others who are knowledgeable (eg brokers, tax preparers) Conflict of interest rules apply

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Get The Word Out About Enrollment

Put an article in your newsletter• In your next newsletter you can drop in this article from

the www.healthcare.gov web site.

• Excerpt: No doubt you’ve been starting to hear about the new Health Insurance Marketplace, a key part of the health care law that will be open for business on October 1st. But you probably still have questions …

• Find the full version at: http://marketplace.cms.gov/getofficialresources/publications-and-articles/relaunch-drop-in-article.pdf

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Get Involved!

• Reach out to UHCAN Ohio to help you as you pursue your work as a Certified Application Counselor.

• Invite UHCAN Ohio to send a speaker to your organization/faith congregation .

• Volunteer with Enroll America to canvass neighborhoods and table

• Stay informed by following us on Facebook and Twitter

• Join our newsletter by signing up on our website34

Thanks for Participating!

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Kathleen GmeinerOhio Consumers for Health Coveragekgmeiner@uhcanohio.org614-456-0060 x223www.ohioconsumersforhealth.org

UHCAN OhioOhio Consumers for Health

@UHCANOhio@KathleenOCHC

A copy of this powerpoint will be sent to you in a follow—up email

Nita CarterUHCAN Ohioncarter@uhcanohio.org614-456-0060 x224www.uhcanohio.org