This workbook is a take-home, interactive resource for the newly enrolled. It covers topics that enrollment assisters may not have time to cover during the enrollment appointment, such as how to find a primary care provider, how to make your first appointment, and even how to make a budget. People can fill in the workbook with their own information so they have all of their important health coverage information in one place. Download the workbook here.
Georgians for a Healthy Future is excited to release our new enrollment toolkit! The toolkit is a comprehensive compilation of fact sheets, neatly organized, that are designed to walk consumers through each step of the enrollment process – from how to get health insurance (enrollment) to how to use health insurance once they have it (post enrollment).
Need more information like this? You’re in luck! GHF has created the GEAR Network for people just like you. GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners that are working with people to educate them on their health and health coverage options. We’ll send out weekly emails full of local resources and the information you need to know through OE3 and beyond. For more information on GEAR, check out this presentation.
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Who, what, when, where and why
By Pranay Rana
Pranay is GHF’s Consumer Education and Enrollment Specialist. A certified application counselor, he assists consumers with enrollment into health insurance through the Marketplace. Pranay can also help you once you have enrolled with questions about how your coverage works. To set up a meeting with Pranay you can email him or give him a call at 404-567-5016 x4.
Open Enrollment 2016 (OE3) is less than 10 days away! Open enrollment is an annual period when individuals and families can choose from a variety of coverage options in the marketplace, apply for tax credits, and purchase a health plan that best meets their needs. Consumers can get 24/7 over-the-phone enrollment assistance via the Health Insurance Marketplace at 1-800-318-2596 or can find local in-person assistance at localhelp.healthcare.gov. Individuals and families with incomes between 100% and 400% of the 2015 federal poverty level (FPL) may be eligible to receive financial assistance to help pay for their monthly premiums (see the chart below for what FPL means in real dollars). Consumers with lower incomes (between 100% and 250% of the FPL) may be eligible for additional help with out-of-pocket costs if they choose a “silver” plan. In 2015, 9 out of 10 Georgians who enrolled into marketplace plans were able to access tax credits. Consumers who do not qualify for subsidies may still be able to purchase plans through the marketplace at a full price.
So, when does my coverage start?
|Coverage Dates||Enrollment Deadlines|
|January 1, 2016||December 15, 2015|
|February 1, 2016||January 15, 2016|
|March 1, 2016||January 31, 2016|
The marketplace will discontinue subsidies for those consumers who did not fulfill their tax filing requirements for 2014 in order to reconcile their income and subsidies at the end of the year. Consumers are advised to fulfill their tax filing requirements every year and call the marketplace or local assisters for help if subsidies are being dropped without any legitimate reasons. Consumers who do not qualify for subsidies because their income is too low are also advised to obtain an Exemption Certificate Number (ECN) to avoid tax penalties.
What do I need to do to renew my existing plan?
You may simply call the marketplace for 2016 application renewal if you need to change plans for 2016 or update your information. If you are happy with your existing plan and have no updates to make then you do not need to do anything. The marketplace will simply auto-renew your application for 2016.
What if I need help?
- You can call GHF’s enrollment assister at 404-331-9981 or email email@example.com
- You can call the marketplace 24/7 at 1-800-318-2596
- You can also find local help at healthcare.gov.
Federal Poverty Level Table, 2015
Do you or does your organization work directly with consumers to help get them covered? Do people in your community come to you with questions about how to make sense of their health insurance? If so, GEAR is for you! Please join us for a webinar to introduce the new Georgia Enrollment Assistance Resource Network — GEAR! GEAR is the new central hub of resources for Georgia’s enrollment assisters and stakeholders who work to educate people on their health and health coverage options. GEAR is full of handouts, interactive consumer tools, important updates, and other materials that will help enrollment assisters and community organizations better educate Georgians on health insurance enrollment, health insurance literacy, and more.
Want to learn more about GEAR and how you and/or your organization can benefit? Join us on October 19th for a webinar where we will demonstrate how to access GEAR and review some of the materials that can be found there. We will also get your feedback about other resources you would like to see included on GEAR in the future. GEAR is built to help more Georgians connect to health coverage and we want it to work for you!
You can register for the October 19th GEAR webinar here.
GHF conducted in-depth interviews with and survey of enrollment assisters across the state to identify best practices and lessons learned from open enrollment 2. Here’s a summary of what worked, what didn’t, and what we can improve on next year.
What worked during OE 2: Successful strategies and best practices
Using a variety of local venues to conduct extensive outreach. Across the board, enrollment assisters identified the importance of conducting a broad range of outreach and enrollment activities at the local level. They identified a variety of venues where they successfully reached consumers including libraries, churches, college campuses, Volunteer Income Tax Assistance (VITA) sites, doctor’s offices, community health centers, cooperative extension offices, small businesses, AIDS service organizations, and local hospitals. For example, one navigator organization worked with a nurse navigator who met with uninsured consumers who presented at the emergency room at the local hospital. The nurse navigator connected these uninsured consumers to a navigator organization, allowing the organization to reach a much larger pool of consumers than if they had not had this partnership. Enroll America also provided significant support to assisters’ outreach and enrollment efforts. Assisters were limited in their ability to retain personal information about consumers, but because Enroll America only provided outreach and education, they could retain contact information and follow up with consumers seeking more information about the Marketplace.
Leveraging the support of existing partnerships for outreach. All of the assisters interviewed acknowledged that one of their best methods for reaching consumers was building upon existing relationships with community organizations. One group wrote letters to community partners letting them know of their navigator services, which created more awareness in their communities. Another enrollment assister organization had deep ties with Family Connection Partnership organizations in their area, which allowed them to have a well-known partner in each of the counties that they covered.
These partnerships allowed the enrollment assister organizations to use existing frameworks of community organizations to educate and provide enrollment assistance to the populations served by these groups. Because of the strong presence and history these partner organizations have in the communities they serve, consumers also viewed them as credible.
Developing trust with consumers. One of the most critical aspects of providing enrollment assistance was for assisters, and their organizations, to be recognized as a trusted resource within their communities. This was especially true for assisters working with immigrant and non-English speaking populations. One Spanish-speaking enrollment assister noted that it put consumers at ease to have a native speaker, rather than someone speaking Spanish as a second language, helping them to enroll. Additionally, due to the strong anti-ACA sentiment in the state, enrollment assisters reported that it was critical to be considered a trusted resource in order to overcome ideological barriers.
Reaching large numbers of people through events and local media. Enrollment events served as valuable opportunities for assisters to efficiently reach large numbers of people. For example, one of the navigator grantee organizations organized large events in rural communities to provide centralized assistance to a larger pool of consumers. These events were marketed in the local media using radio spots, newspaper ads, and movie theater ads. Additionally, some assister organizations used local media outlets to reach a large number of consumers. One organization in South Georgia held a phone bank with a local television station. The organization reported that following this event, their call volume of consumers looking for enrollment assistance picked up substantially.
What challenges and barriers remain for consumers?
Enrollment assisters identified several challenges in enrolling uninsured consumers and noted some barriers that some uninsured Georgians still face.
Many consumers had limited health insurance literacy. More than two-thirds of our survey respondents identified low health insurance literacy as a barrier to enrollment. Many of the consumers that assisters worked with had never been insured before, so they did not know how to choose a primary care physician or pay their monthly premium. One of the assisters interviewed acknowledged they needed to educate consumers on how to use their health insurance, but that it was a challenge when scheduled with a large number of enrollment appointments. Additionally, some assisters reported that consumers chose the lowest premium plan because they did not understand the concept of a high deductible. Sometimes consumers would return to the assister wanting to change plans once they had tried to use their coverage.
Many consumers fell into the coverage gap. Assisters encountered a large number of individuals and families that fell into the coverage gap, meaning that they did not qualify for Medicaid or subsidies to help them pay for Marketplace coverage and were left without an affordable pathway to coverage. Some assister organizations estimated that over half of the consumers they worked with fell into the gap. Enrollment assisters were able to provide these consumers with a list of resources where they could go to get free or low cost care, but indicated frustration at not being able to do more to help. One navigator described it as emotionally taxing to repeatedly tell consumers that came to them looking for assistance that they were too poor to qualify for health insurance.
Immigrants faced verification and language barriers. Immigrants faced many challenges enrolling in coverage. Assisters reported that, when the consumer did not speak English and the assister did not speak the consumer’s native language, using interpreter services was difficult and often ineffective. Language barriers also created difficulty because key terms and concepts associated with health insurance do not translate well. The biggest barrier for immigrants, though, was identity verification. Enrollment assisters had little or no training on how to properly verify IDs or immigration forms. Additionally, technological problems sometimes prevented them from uploading these documents to healthcare.gov. When they were unable to upload these documents electronically, consumers had to verify their immigration status through the mail, which was a long and cumbersome process. There was also a common concern from families of mixed immigration status that sharing information about their families would lead to legal repercussions. Even though none of the immigration or family information shared with the Health Insurance Marketplace is used to identify immigrants that are not here legally, this is a misconception held by many
Confusion and political opposition to Affordable Care Act hindered partnerships. Stakeholders reported that confusion and political hostility created significant barriers to outreach and enrollment. In addition, the passage of the “Health Care Freedom Act” as part of HB 943 in 2014, which included language prohibiting state and local governmental entities from operating a navigator program, among other provisions, led to confusion among local health departments and other governmental entities regarding their participation in helping consumers enroll in health insurance. An earlier version of this legislation that was not enacted, HB 707, was even more restrictive than the final language that passed and the media coverage over that bill added to the confusion. Most of these entities opted for caution, which meant that potentially powerful partnerships for enrollment were missed. This legislation also ended the University of Georgia’s navigator program (The University of Georgia operated a navigator program through its cooperative extension service during OE1).
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From choosing a plan to using your plan, health insurance can be complicated and many Georgians lack the information they need to make informed decisions. In GHF’s recent report [LINK] Getting Georgia Covered: Best Practices Lessons Learned and Policy Recommendations from the Second Enrollment Period, we interviewed enrollment assisters across the state and found that more than two-thirds of our survey respondents identified low health insurance literacy as a barrier to enrollment. Many of the consumers that assisters worked with had never been insured before, so they did not know how to choose a primary care physician or pay their monthly premium. One of the assisters interviewed acknowledged they needed to educate consumers on how to use their health insurance, but that it was a challenge when scheduled with a large number of enrollment appointments. Additionally, some assisters reported that consumers chose the lowest premium plan because they did not understand the concept of a high deductible. Sometimes consumers would return to the assister wanting to change plans once they had tried to use their coverage. As we move forward, Georgians for a Healthy Future will be focusing efforts on improving the health literacy of Georgians and ensuring they have the knowledge, information, and confidence they need to make informed decisions.
New health insurance opportunities created through the Affordable Care Act (ACA ) have led to historic reductions in the nation’s uninsured rate. Here in Georgia, more than half a million consumers signed up for health insurance during the open enrollment period that ended this past February, known as OE 2.
These strong enrollment numbers mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families. The reduction in our state’s uninsured rate, although smaller than that of the nation as a whole, also has positive implications for the vitality of local health care systems and communities throughout Georgia.
Too many Georgians, however, remain uninsured, either because
- they are unaware that there are coverage options that can meet their needs and budget
- face cultural, linguistic, financial, or other barriers to coverage; or
- fall into the “coverage gap” that was created when Georgia declined to expand Medicaid as authorized under the ACA
The goals of this report are
- to explain the role of in-person assistance on enrollment outcomes and consumers’ experiences
- to explore best practices that helped achieve robust enrollment in Georgia
- to identify any common challenges or barriers to enrollment that Georgia consumers faced during OE2
- to highlight promising strategies and approaches to reach the remaining uninsured who qualify for affordable health insurance
- to put forth policy recommendations that can help facilitate a positive experience for health care consumers, both for those who are newly enrolled and for those who remain uninsured.
You can download and read the report below.
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May 13, 2015 from 11:30 to 2:00
Georgia Railroad Freight Depot; Blue Room
Sign up here!
More than half a million Georgians signed up for health insurance during the open enrollment period that ended this past February (OE2). These strong enrollment numbers mean that more Georgians have access to the health care services they need and the peace of mind that comes from knowing that they are covered. What drove this success story for health care consumers in Georgia? Please join us for a conversation with representatives of the organizations most active in OE2 to learn lessons about their strategies, successes, and challenges that you can apply to your work. After their presentations, you will have the opportunity to ask your most pressing questions about health coverage in Georgia. Lunch will be provided.
Enroll America: Danté McKay, Georgia State Director
GHF: Whitney Griggs, Consumer Education Specialist
InsureGA: Sarah Sessoms, Executive Director
SEEDCO: Lisa Stein, Vice President Work and Family Supports
US Dept. of Health & Human Services: Dr. Pamela Roshell, Region 4 Director
While this is a free event, please RSVP so we can order enough food.
Pranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace. Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012. He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future. He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya, he can be reached by email or by phone at 404-567-5016.
Did you go without health insurance in 2014 and are now subject to a tax penalty? Good news! – You may still be able to enroll in coverage through the Health Insurance Marketplace. Starting last Saturday, March 15th, some people who are facing a fine on their taxes for not having coverage can now enroll in the Marketplace through a time-limited special enrollment period. To be eligible for this special enrollment period, you must not be currently enrolled in health insurance, attest that you owe the penalty for 2014, and attest that you first became aware of the penalty when you filed your 2014 taxes. This tax-related special enrollment period will run through April 30th, 2015. Click here to learn more about who can qualify for this special enrollment period.