round two: prepare for success in the second open enrollment period

© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014

Click to edit master title style.

1

Round Two:

Prepare for Success in the Second Open Enrollment Period (OE2)

October 2, 2014

© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 2

Agenda

I.  Introductions and Enrollment Landscape

Jennifer Sullivan, Director of the Best Practices Institute,

Enroll America (Moderator)

II.  OE2 Enrollment Basics Sophie Stern,

Deputy Director of the Best Practices Institute, Enroll America

III.  OE2 Messaging Jonathan Shields,

Spokesperson Coordinator, Enroll America

IV.  Consumer Tools Adam Stalker, National Digital Director, Enroll America

V.   Q&A Submit your questions at any time using the chat box.


I. ENROLLMENT LANDSCAPE


What’s Staying the Same

•  Financial help •  Populations that are likely to

be uninsured •  The importance of in-person

assistance •  The core message about the

value of coverage •  Technology bumps •  Enroll America will continue to

serve as a resource

What’s Changing

•  Shorter open enrollment period •  Renewals! •  Fine increasing •  Some states expanding

Medicaid for the first time •  Who the in-person assisters

are in your community •  Training for assisters •  Funding •  Tax Time

How is OE2 different from OE1?


You = More Important than Ever!

There are fewer uninsured individuals to connect to coverage, but our work remains more important than ever…


2014 Enrollment

16 Million


2014 + 2015 Enrollment

16 Million in year 1

8 Million in year 2


OE2 3 months: Nov. 15, 2014 to Feb.15, 2015

Medicaid & CHIP Year-Round Enrollment

Special Enrollment Periods After qualifying life event (year-round)

Tax Filing Jan. 31, 2015 to April 15, 2015

Important Dates


Coverage Effective Dates

Enroll by… For coverage beginning..

December 15, 2014 January 1, 2015

January 15, 2015 February 1, 2015

February 15, 2015 March 1, 2015


II. OE2 ENROLLMENT BASICS


Before We Get Started…

Rules will vary state to state, especially in state-

based marketplaces (SBMs)!


New Enrollees and Renewals

•  Millions of uninsured consumers are still eligible to receive financial help through the marketplace.

•  Just like OE1, the renewal process is new and will require some learning on the fly.

•  In-person assistance, in-person assistance, in-person assistance!


Our Core Message

Get Covered. Stay Covered.


Auto-Renewal

A safety net for marketplace consumers


Marketplace Renewal Process

Consumer Changes

Plan Changes

•  Income •  Family

Size •  Health

care needs

•  Premiums •  Provider

network •  Cost

sharing •  Cost

relative to other plans

Need for Consumer

to Take Action

•  Know your costs, financial help, plan details

•  Choose the right plan for health needs and budget


Marketplace Renewal Process

Consumer updates

information

Consumer stays

covered

Consumer keeps plan or shops for a new

plan


Marketplace Renewal Notices

Current marketplace enrollees will receive at least three notices between now and November 15: •  Two from their health

insurance company; one from the marketplace

•  All notices will contain different info– consumers will need your help!


Now…Medicaid Renewals

If Medicaid agency has enough information, consumer renewed automatically

If Medicaid agency does NOT have

enough information

Medicaid is renewed or consumer is

referred to marketplace/CHIP

Consumer is notified and

must take action


Reconciliation Process for Premium Tax Credits

Financial help eligible to

receive in 2014

Financial help actually

received in 2014

Amount consumer owes IRS or

amount IRS owes consumer

$$$$ $$ - $$ $$ $$$$ + $$


Repayment Limits for Advanced Premium Tax Credits

Income as percentage of poverty line

Repayment limit for single taxpayers

Repayment limit for married taxpayers

filing jointly

Under 200% FPL $300 $600

200% FPL-300% FPL $750 $1,500

300%FPL-400% FPL $1,250 $2,500

400% FPL and above Full amount Full amount

Source: State Health Reform Assistance Network, October 29, 2013, http://www.statenetwork.org/wp-content/uploads/2013/10/State-Network-Manatt-APTC-Reconciliation-Webinar.pdf


The Fine Is Going Up

Year Fine for consumers without coverage

2014 $95 or 1% of annual income, whichever is greater

2015 $325 or 2% of income, whichever is greater.

Remember, some consumers are exempt from the fine.


What’s Staying the Same •  Providers, including health

centers, can serve as assisters •  Assisters must meet state

licensing, certification, and registration policies

•  Assisters are required to undergo training and receive certification (& recertification)

•  Assisters are prohibited from charging for providing assistance

•  Assisters may conduct outreach and education activities by going door-to-door and through other unsolicited means, including calling a consumer

What’s Changing •  Organizations cannot pay

assisters on per-enrollee, per-application basis (applies to FFM states only)

•  Automatic calling systems (e.g. robocalls) are prohibited unless there is a pre-existing relationship with the consumer

•  Written consent is required before accessing personally identifiable information (PII) or reaching out to consumers about enrollment or retention of coverage

Considerations for Assisters


III. OE2 MESSAGING


The Remaining Uninsured

Consumer research:

•  Most feel they can’t afford insurance

•  Not hearing positive things about ACA

•  Even more skeptical


The Remaining Uninsured

•  Don’t have room in their budgets

•  Shopped last time but felt the costs weren’t worth it

•  Discouraged by difficulty of the process


The Newly Enrolled

•  Have mixed feelings about their plans, but thankful they have insurance

•  Interested in shopping around

•  Not yet thinking about renewing

•  Need to know about changing financial help


What Do They Need?


Making Financial Help Real

•  “Financial help is here” isn’t enough anymore: they need proof

•  What does work: •  Localize it •  Compare it to other bills •  Tell a story from your state


Our Approach

What’s Staying the Same What’s Changing

Leading with financial help Get more specific with financial help, tell a story


Our Approach

What’s Staying the Same What’s Changing Promoting help with the

process Emphasizing in-person help


Our Approach


Get Covered Stay Covered


Our Approach

What’s Staying the Same What’s Changing Leading with security, peace

of mind Giving details of the fine to

“close the deal”


Our Approach


“Just the facts” More local details of the facts


Our Approach

What’s Staying the Same What’s Changing “New” way to shop for health

insurance “New” plans may be

available


Communicator’s Guide 2.0



Step One: Lay Out the Facts Including the Consequences of Going Uninsured •  Marketplace offers new, quality health insurance

and financial help to pay for it •  Health insurance means protection from big

medical bills or going bankrupt •  All plans have to cover important benefits •  If you don’t have health insurance, you may have

to pay a fine of at least $325



Step Two: Address Misconceptions of Affordability •  7 out of 10 Americans who signed up are paying

$100 per month or less •  ____% in state who signed up qualified for

financial help •  The average person in state is paying $_____ a

month for coverage, less than a cable bill



Step Three: How, When, Where to Sign Up •  Enrollment takes place between November 15,

2014 – February 15, 2015 •  You can get free, in-person help to guide you

through your options •  Visit GetCoveredAmerica.org


IV. OE2 CONSUMER TOOLS


Continued Development of Tools

•  Multiple surveys have shown that 60% of enrollees did so via in-person assistance and 40% did so online with little assistance

•  Our goal: Make both paths more efficient •  Focus on affordability, plan selection, and finding in-

person assistance •  And help both consumers enrolling online AND in-

person assisters


Financial Help Tools

Similar to last enrollment period, we will offer an embeddable, co-branded calculator to partners that help consumers understand what subsidies they might qualify for, a range of costs for insurance plans to expect in the marketplace, and where to go to start the enrollment process. Additional features that could be coming include estimating the fine uninsured consumers could face and QHP shopping comparison tools.


Local Assistance Help

Similar to last enrollment period, we will curate a list of assisters (all varieties, including agents & brokers) to offer partners an embeddable, co-branded assister locator tool. We need the help of our partners to ensure this list is as comprehensive as possible.


Schedule an Appointment Online

We’re introducing a new tool for partners and consumers: the Get Covered Connector. Partners can contract with Enroll America to list their assistance locations and available appointments for consumers to search through and schedule appointments online. The Connector will allow partners to manage all of their schedules in one place, including reporting on outcomes of all appointments.


Interested in the Connector?

•  We’re building coalitions at the state level and working with regional and national partners

•  Cost: •  For-profit pricing: $20,000 for 250 logins, $10,00 for additional

batches of 250 logins •  Non-profit pricing: $10,000 for 250 logins, $5,000 for additional

batches of 250 logins •  Lead partners manage distribution of logins to their partner

network •  Enroll America provides initial training and ongoing

technical support

Email [email protected] to learn more.


V. QUESTIONS?


#Ready4OE2 Series

#Ready4OE2 Webinar and Blog Series During October!

Subscribe to Enroll America’s newsletter for updates:

http://www.enrollamerica.org/

round two: prepare for success in the second open enrollment period

Healthcare