round two: prepare for success in the second open enrollment period
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© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014
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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.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 3
I. ENROLLMENT LANDSCAPE
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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?
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You = More Important than Ever!
There are fewer uninsured individuals to connect to coverage, but our work remains more important than ever…
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2014 Enrollment
16 Million
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2014 + 2015 Enrollment
16 Million in year 1
8 Million in year 2
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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
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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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 10
II. OE2 ENROLLMENT BASICS
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Before We Get Started…
Rules will vary state to state, especially in state-
based marketplaces (SBMs)!
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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!
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Our Core Message
Get Covered. Stay Covered.
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Auto-Renewal
A safety net for marketplace consumers
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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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 16
Marketplace Renewal Process
Consumer updates
information
Consumer stays
covered
Consumer keeps plan or shops for a new
plan
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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!
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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
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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
$$$$ $$ - $$ $$ $$$$ + $$
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 20
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
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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.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 22
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
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III. OE2 MESSAGING
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The Remaining Uninsured
Consumer research:
• Most feel they can’t afford insurance
• Not hearing positive things about ACA
• Even more skeptical
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 25
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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 26
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
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What Do They Need?
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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
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Our Approach
What’s Staying the Same What’s Changing
Leading with financial help Get more specific with financial help, tell a story
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Our Approach
What’s Staying the Same What’s Changing Promoting help with the
process Emphasizing in-person help
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Our Approach
What’s Staying the Same What’s Changing
Get Covered Stay Covered
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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”
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Our Approach
What’s Staying the Same What’s Changing
“Just the facts” More local details of the facts
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Our Approach
What’s Staying the Same What’s Changing “New” way to shop for health
insurance “New” plans may be
available
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Communicator’s Guide 2.0
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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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 37
Communicator’s Guide 2.0
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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 38
Communicator’s Guide 2.0
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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 39
IV. OE2 CONSUMER TOOLS
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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
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 41
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.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 42
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.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 43
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.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 44
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 connector@enrollamerica.org to learn more.
© 2014 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014 45
V. QUESTIONS?
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#Ready4OE2 Series
#Ready4OE2 Webinar and Blog Series During October!
Subscribe to Enroll America’s newsletter for updates:
http://www.enrollamerica.org/
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