Certified Application Counselors
In Ohio
Nita Carter, Health Equity Director
UHCAN Ohio
Recruiting Certified Application
Counselors:
What will be covered:
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Overview of Navigation in Ohio
Recruiting Certified Application Counselor
Organizations
Providing Technical Assistance
Legislative Advocacy
Engaging Faith and Community Based Programs in
Navigation
Future Trends
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Ohio’s Navigation System:
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Navigators
Federally Qualified Health Centers
Certified Application Counselors
Cognasante
SAR
Agents and Brokers
ONCE
Regional Enrollment Assistor Tables
Recruiting Certified Application
Counselor Organizations:
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Identified Programs working in communities who
should be a part of the Navigation System
Used the organizations we worked with around CTG grants and
the UHCAN Ohio Health Equity Committee to help us Identify
programs
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Convened regular statewide conference calls to
educate them on navigation under the ACA and
prepare them for the navigation grants coming out.
Held CAC orientations in 4 Cities across the state.
Convened follow-up calls for those organizations
who decided to become CAC’s.
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Providing Technical Assistance to
Faith and Community Based
Organizations:
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Regular updates on navigation process, what is
working and what is not;
Provide information from the various networks and
offices, (ONCE, regional assistor tables, Community
Catalyst, In the Loop and CMS);
Assist with filling out CAC Applications, setting up
their programs and provide sample documents and;
Available by phone to answer questions and
participate by phone or in person for first enrollment.
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Legislative Advocacy:
Engaged faith and community based programs in
advocating against HB3 and SB9.
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Developed testimony, draft language and
participated in legislative stakeholder meetings.
Signed onto a letter asking Ohio’s Department of
Insurance to become a Consumer Assistance State
Partnership Exchange.
Developed recommendations for effective navigation in
communities of color.
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How Are they Involved in
Navigation:
Participated in the joint navigator application of the Ohio
Association of Food Bank;.
Became Certified Application Counselors and;
Working with the Navigator Organizations in their area to
host events and refer people they work with to enrollment
Assistors.
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Future Plans/Trends:
Building the infrastructure among community and faith
based organizations to:
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Become a part of the feedback loop on what is
working and what is not with respect to enrollment,
linking to care and new models of care.
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Participate in future ACA implementation planning
and delivery system reform .
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Sample Training Materials
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Certified Application Counselor
• Sample Training Materials.
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Overview
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Basics of the ACA
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Medicaid Expansion
Health Insurance Marketplace
Navigators
Mandate
What You Can Do to Help Your Members/Clients
Now
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The Affordable Care Act Expands
Access to Coverage
Medicaid Expansion
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All adults up to 138% of the Federal Poverty Level
($15,856 per year for household of one) are eligible if Ohio
accepts the expansion of Medicaid
Private insurance through the Marketplace
(Exchange)
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Offers choices of private insurance plans
(Qualified Health Plans – QHPs) with
financial help available to those who qualify.
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Health Insurance Marketplace in
2014
Creates one-stop shop
for easy comparison of
coverage options
Interesting Fact
about the
Marketplace:
Gives consumers more
choice and control
Congress will get its coverage
through the same Marketplaces.
Subsidies for individuals
and tax credits for small
businesses are available
to make it more affordable
Offers coverage options
through a website and
helpline
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What A Household of One Can Expect
to Pay with a Tax Subsidy
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Navigators – How to Get Help with the
Marketplace
The Marketplace is required to create a navigator program
to:
• Inform people about their new insurance options
• Help people enroll in their plan of choice
• Help people keep their coverage (stay enrolled)
Insurance brokers and agents can also help.
The Navigator does not choose a plan or
advise which plan to choose.
Navigators may not be compensated by insurers to enroll people in
the Marketplace, and Ohio’s HB 3 is disqualifying providers
reimbursed by insurers for medical services provided.
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Navigators Serving Ohio
• Helping Hands Community Outreach Center
(Dayton)
• Call 937-268-6066
• Anticipated grant amount: $230,920
• Neighborhood Health Association (Toledo)
• Call 419- 720-7883
• Anticipated grant amount: $684,630
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Navigators Serving Ohio
• Ohio Association of Foodbanks
(Serving most parts of Ohio)
• Call 614 221-4336
• Anticipated grant amount: $1,958,961
• Clermont Recovery Ctr, Inc. (Clermont,
Brown and Adams Counties)
• Call Tammy Altman at 513- 735-8100
• Anticipated grant amount: $44,938
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Navigator Collaborative of the Ohio
Association of Food Banks
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Ohio Association of Foodbanks, All 88 Counties
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Access Health Mahoning Valley (AHMV), Mahoning and Trumbull Counties
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Asian Services in Action, Inc. (ASIA), Cuyahoga, Franklin, Hamilton, Lucas, Montgomery,
and Summit Counties
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Carmella Rose Health Foundation (CRHF), Cuyahoga County
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Cuyahoga Health Access Partnership (CHAP), Cuyahoga County
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Community Action Committee of Pike County (CACPC), Jackson, Pike, and Scioto
Counties
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Disability Rights Ohio (DRO), All 88 Counties
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Health Care Access Now (HCAN), Adams, Brown, Butler, Clermont, Hamilton, and
Highland Counties
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Heart of Ohio Family Health Center (HOFHC), Franklin County
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Navigator Collaborative of the Ohio
Association of Food Banks
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Hospital Council of Northwest Ohio (HCNO), Allen, Ashland, Auglaize,
Crawford, Defiance, Erie, Fulton, Hancock, Hardin, Henry, Huron, Lucas,
Mercer, Ottawa, Paulding, Putnam, Richland, Sandusky, Seneca, VanWert,
Williams, Woods, and Wyandot Counties
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Ohio Association of Free Clinics (OAFC), 40 Counties Across Ohio
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Ohio Department of Health (ODH), All 88 Counties
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United Way of Greater Cleveland 2-1-1 (UWGC), Ashland, Cuyahoga,
Geauga, Holmes, Medina, Portage, and Wayne Counties
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The Community Action Program Corporation of Washington Morgan
Counties (WMCAP), Morgan and Washington Counties
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Western Reserve Area Agency on Aging (WRAAA), Cuyahoga, Geauga,
Lake, Lorain, and Medina Counties
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How to Help Your Members/Clients
• Become a Certified Application Counselor
Organization
• Get the word out about Enrollment
• Encourage them to visit healthcare.gov and sign up for
email updates
• Include articles in your newsletter
• Print materials/handouts
• Invite Enroll America to your meetings
• Schedule a presentation with UHCAN Ohio
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Become a Certified Application
Counselor (CAC)
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CACs are trained by the federal government to help
people understand their choices under the Affordable
Care Act. The training is free.
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CACs are usually people working in agencies or
organizations that help people secure health care or
other benefits.
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CACs are not paid by the federal government to do
their work, but some private money may be
available.
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How to Become A CAC
1. Find out what is required of a CAC.
http://marketplace.cms.gov/help-us/cac.html
2.Fill out an application on-line found at
http://marketplace.cms.gov/help-us/cac-apply.html
(Application takes about 15 minutes to fill out)
3. Someone from Center on Consumer Information
and Insurance Oversight (CCIIO) will contact those
organizations who appear to have the qualifications
to get more detail.
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How to Become a CAC (continued)
An organization that wants to be a CAC should:
1. Already be helping people to secure
assistance of some kind.
2. Have a system for protecting confidential
client data
3. Screen employees and volunteers who help
clients and handle sensitive information
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Becoming a CAC (continued)
4. Be aware of any relationships with insurance
companies or others that could pose a conflict
of interest and be prepared to discuss with
CCIIO.
5. Be prepared to enter into a written
agreement with CCIIO.
6. Identify who in your organization will be
trained to be a CAC.
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What are the benefits to becoming
a designated CAC organization?
A: CAC designated organizations will benefit by
receiving the Marketplace’s training and being able to
represent themselves to consumers as being certified
by their state’s Marketplace to provide application and
enrollment assistance.
In addition, becoming a CAC will build the capacity of
the organization’s staff and volunteers which will build
their own marketability.
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Training To Be a CAC
How will training work?
A: Because the CAC training is web-based, it can be completed at any
time. Individual CACs must complete the training before being certified
by their designated CAC organization.
How many hours will the CAC training be?
A: Approximately 5 hours.
Do all of our employees/volunteers need to take the
training or just those it wants to certify to be CACs?
A: Only those who will be certified to be CACs are required to take and
pass the CAC training.
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Screening to Be a CAC
What does it mean to screen staff and volunteers
who would become individual CACs?
A: Screening could involve background checks, calling past employers
for references, checking government-issued identification, or other tools
that will tell whether the organization can trust its staff and volunteers to
handle any private consumer information responsibly and securely, to
adhere to all CAC program requirements and standards, and to act in
the best interest of the consumers they assist.
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Screening to be a CAC
What level of health care knowledge should an
individual already have to become a CAC?
A: There is no minimum level of knowledge required for an individual to
be certified as a CAC, other than completing the required CAC
training. The training will teach each individual CAC everything he or
she needs to know to help consumers apply for and enroll in coverage.
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Role of CAC
Can a CAC actually help an individual compare health
plans and assist the individual in choosing a health
plan?
A: Yes, those are required duties of a CAC. But remember that a CAC
cannot actually choose a plan or enroll someone in a plan. A CAC may
only assist with plan selection and enrollment, and must provide this
assistance in the consumer’s best interest.
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Role of CAC
Are there quotas for how many consumers each CAC
or designated CAC organization must assist?
A: No. There are no requirements regarding the minimum number of
consumers a designated CAC organization or each CAC must assist.
About how long on average will it take a CAC to walk a
consumer through enrollment?
A: It will vary depending on the consumer’s needs. We estimate that it
will take about one hour to walk a typical client through the entire
process.
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Difference Between and CAC and a
Navigator?
Navigators:
CACs:
• Funded through grants
through the Marketplace
• Not funded through
Marketplace but may
obtain finding from other
sources
• Strict conflict of interest
requirements
• Required to conduct
outreach and education
• Conflict of interest
disclosure requirements
but won't prevent from
becoming a CAC
• Not required to conduct
outreach and education
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Difference Between CAC and
Broker?
A: Unlike agents and brokers, CACs cannot charge
consumers for their assistance and are not paid by health
insurers to sell insurance. Agents and brokers are licensed
by their state to sell insurance. CACs do not sell insurance,
nor will they be enrolling individuals in health coverage,
including QHPs offered through the Marketplace.
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How to Become a CAC (continued)
Think through how you plan to help people.
• Will you establish an appointment system?
• Will you set up certain days of the week that you have
“first come, first serve” clinics?
• Will you partner with others who are knowledgeable (eg
brokers, tax preparers) Conflict of interest rules apply
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Get The Word Out About Enrollment
Put an article in your newsletter
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In your next newsletter you can drop in this article from
the www.healthcare.gov web site.
Excerpt: No doubt you’ve been starting to hear about
the new Health Insurance Marketplace, a key part of
the health care law that will be open for business on
October 1st. But you probably still have questions …
Find the full version at:
http://marketplace.cms.gov/getofficialresources/publicati
ons-and-articles/relaunch-drop-in-article.pdf
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Get Involved!
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Reach out to UHCAN Ohio to help you as you
pursue your work as a Certified Application
Counselor.
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Invite UHCAN Ohio to send a speaker to your
organization/faith congregation .
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Volunteer with Enroll America to canvass
neighborhoods and table
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Stay informed by following us on Facebook and
Twitter
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Join our newsletter by signing up on our website
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Thanks for Participating!
Nita Carter
UHCAN Ohio
ncarter@uhcanohio.org
614-456-0060 x224
www.uhcanohio.org
Kathleen Gmeiner
Ohio Consumers for Health Coverage
kgmeiner@uhcanohio.org
614-456-0060 x223
www.ohioconsumersforhealth.org
UHCAN Ohio
Ohio Consumers for Health
@UHCANOhio
@KathleenOCHC
A copy of this powerpoint will be sent to you in a follow—up email
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