Get Covered in OE2: Key Dates, Renewal Process

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EnrollAmerica.org | GetCoveredAmerica.org 10-2-2014
© 2014 Enroll America and Get Covered America
1
Round Two:
Prepare for Success in the Second
Open Enrollment Period (OE2)
October 2, 2014

Agenda
2 © 2014 Enroll America and Get Covered America
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

How is OE2 different from
OE1?
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

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

Important Dates
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

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.

Considerations for Assisters
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

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
Promoting help with the
process Emphasizing in-person help

Our Approach
Get Covered Stay Covered

Our Approach
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
“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 connector@enrollamerica.org 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/

Get Covered in OE2: Key Dates, Renewal Process

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