Consumer assistance for open enrollment 2017

This year, for the first time since the health insurance marketplace began, states will not have the support of consumer assistance funding from the Centers for Medicare and Medicaid Services (CMS) to educate the public about marketplace plan offerings. Without federal funding, many states are scrambling to find ways to assist consumers in the upcoming open enrollment period.

CMS has started promoting consumer assistance tools available to states and consumers for 2017, including FAQ’s, fact sheets and useful blogs:

• Healthcare.gov blog to help consumers find out if they qualify for a Special Enrollment Period(SEP) for Marketplace health insurance coverage or if they qualify for Medicaid or Children’s Health Insurance Program (CHIP) coverage after experiencing certain major life changes.
• A list of the types of health insurance losses that may qualify consumers for an SEP along with additional information.
• Some of the most common Marketplace health insurance questions with detailed answers for consumers.
• New fact sheets that outline the action that needs to be taken by a consumer who is turning 26 this year and has health insurance under a parent’s plan, and three reasons why young adults need health coverage.

States have also started creating open enrollment assistance documents and fact sheets to educate consumers; for example, New Hampshire has developed plan compare documents for consumers to compare details of the plans side by side. Additionally, the consumer division of the Department of Insurance is trained to understand these documents and direct consumers to the plan compare for use while making decisions about what plan works best for themselves or their families. Click here to see examples of these documents.

Also, Arkansas worked with the broker community to create a plan compare tool that also allowed brokers to see costs based on rating variables. This type of assistance not only makes employers and employees lives easier but it ensures accurate information is being disseminated to consumers.

These are just two examples from PCG’s work with state insurance departments and health marketplaces to create consumer assistance tools. Contact Healthpolicynews@pcgus.com to learn more.

Published by Margot Thistle

Margot Thistle, Esq. is a managing editor of Health Policy News who has spent much of her career working directly on Affordable Care Act policy and implementation, including having lead plan management operational and policy planning for Vermont Health Connect, a state-based exchange. During her time at PCG, Ms. Thistle has worked extensively with state insurance departments and state agencies on health policy, market stabilization, and regulatory compliance matters. Ms. Thistle provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Ms. Thistle still has her admission ticket to the signing of Chapter 58 of the Acts of 2006, the historical Massachusetts health reform bill that preceded the ACA. View all posts by Margot Thistle