Outreach & Enrollment

Weekly Outreach and Enrollment Newsletter

The CMS  Assister Newsletter is a great resource for O/E staff to stay up-to-date on information on health insurance marketplace changes, frequently asked questions, and general advice.To sign up, e-mail CACQuestions@cms.hhs.gov with the Subject line “Add to listserv.”

Important Tax Information

Resources & Tools

2018 CMS Assister Certification Training Resources

2018 Assister Certification Training Resources

 

Illinois Department of Insurance CAC certification requirements

Now is the time to make sure your organization and your team is compliant with the Illinois Department of Insurance CAC certification requirements.

Use the link to view an important webinar discussing the steps in certifying or recertifying your organization as a CAC as well as individual CAC certification and recertification. Staff from Illinois Department of Insurance/Get Covered Illinois presented information that will make the process easier. Recording can be found here.

1) New CAC Hire CertificationChecklist

All Certified Application Counselors (CAC) must receivecertification from theIllinois Department ofInsurance(DOI)priorto engagingin consumerassistance and enrollment activities. Pleaseseebelow foracomprehensive checklist of all requirements that an individual must fulfill in orderto receive certification as an Illinois Certified Application Counselor.

CompleteFederal Training through  MLMS

  • Federal TrainingInstructions           

Submityour certificateofcompletionofthefederal training and your 13-digit ID number.

•    Email: DOI.Licensing@illinois.gov; or

  • Fax: (217)557-8455

             Register through NIPR ($5 application fee applies)

2)      Existing CAC Recertification Checklist

All existing Certified Application Counselors (CAC) must complete the recertification requirements within 45 days of their expiration date. CACs who have not re-certified, within 45 days, MUST begin the process as a NEW Certified Application Counselor and should not continue enrollment activities until licensing is complete.

      Complete Federal Training:

      Submityour certificateofcompletionofthefederal training and your 13-digit ID number.

•    Email: DOI.Licensing@illinois.gov; or

  • Fax: (217)557-8455

      Register through NIPR ($5 application fee applies)

3)      CAC Organizations Renewal

            Organizational licenses must be renewed each year 2-3 weeks prior to the expiration date. To renew:

  • Go to www.nipr.com
  • IMPORTANT: If your Organizational Certification has expired you must apply on NIPR as a NEW organization. Once your org is expired you only process at NIPR as a NEW org. You don’t need to go to CMS and reapply. This is a state mandate only. The Federal mandate is a onetime registration with no annual re-certification process for orgs.

 

Please allow two weeks for processing. Certified Application Counselors canlook up their certification information on theDOIwebsite here. If you do not see your status updated after two weeks, please email Tommie Collier Tommie.Collier@illinois.gov to ensure all of the necessary information is on file. If you have any additional questions please contact Carol West, Carol.West@illinois.gov

2019 Assister Certifcation Training Resources

CMS/CCIIO Counselor Designated Organization (CDO) Re-Certification Update:

On May 5th CMS/CCIIO held a Primary Care Association call to share detailed information about the re-certification process for organizations providing CAC services. You can find the link to the recorded webinar here.  A report was ran on May 5th as well to show what organizations have started the process and where they are at in the process of organization re-certification. Note that there are 3 tabs (applications, pending, and done/complete). You can find the slide deck from the webinar here. For “how-to” webinars that walk through the new CDO application, visit Marketplace Technical Assistance and Resources. If you have questions about this process please reach out to Paula Campbell, Associate Director of Marketplace Activities with IPCHA at pcampbell@iphca.org

 

2019 Assister Training Update

CMS is preparing to release the 2019 Assister Certification Training, the 2018 Assister Certification Training that is hosted on the Marketplace Learning Management System (MLMS) will be taken offline at 6:00 p.m. (EST) on Monday June 18, 2018.  During this “go-dark” period, assisters will not be able to access the certification training.  CMS anticipates that the 2019 Assister Certification Training will be available to CACs in July and to Navigators after the next round of Navigator grants are awarded to align with the grant cycle.  Assisters who need to take the current training before the 2019 training is available should begin the 2018 Assister Certification training prior to June 11, 2018 to allow for enough time to complete the training before it is removed June 18th. 

 

CMS CAC Designated Organizations Update

CMS has sent emails to all CAC Designated Organizations (CDOs). 

If your organization didn’t receive this email you can send the name of the CHC and their CDO/CAC organization number to ask who they have listed as the contact and ask that it be changed. Please send the email to CAC Questions cacquestions@cms.hhs.gov and CC pcampbell@iphca.org

Sample Letter

 

Resources for the CDO Agreement Application with CMS

Resources that may help with questions around the renewal process can be found at Champions of Coverage andCDO & Related Resources

If you have questions contact CMS at CACQuestions@cms.hhs.gov  Please reference your application number in the subject line when following up about an existing application.

I am Medicaid IL Campaign

I am Medicaid IL Campaign Launch

A group of Illinois healthcare advocates in partnership with Protect Our Care Illinois is launching a campaign in the next few weeks called #IamMedicaidIL. This campaign is an effort to educate Illinoisans about what Medicaid means for our state and our residents. The campaign is focused on sharing the stories and experiences of children, families, hospitals, health care providers, schools, and others who depend on Medicaid. We will also lift up the role Medicaid plays in the health and economic well-being of communities across Illinois.

The campaign will host a central website where community members can share their experience with Medicaid and highlight what this program has done for them. Individuals can share their experiences by leaving video, photos, and blurbs on this site. We will then be working with our network of partners, media, press, and other allied partners to amplify these stories and create a broader understanding of Medicaid.  

Round One: the launch of the campaign and the website going live to the public by the end of July.

 How Can You Help? If you have any participants or stories in your consumer banks that may be great to post, let us know! We can work with you to help curate the story. #IamMedicaid sign with instructions for videos attached here

Round Two: Round Two will be highlight and gather stories in themes (e.g. special education programs, caregivers, hospitals) and partner with organizations in those sectors to help raise the stories. Please reach out to Kaylan Szafranski at kszafranski@everthriveil.org to get involved or if you have any questions. Here's a one-page I am Medicaid IL explainer to share with your partners.

Mange My Case (MMC) ID Proofing Updates

At the December 2018 MAC Public Education Subcommittee meeting HFS shared updates about MMC. HFS announced starting Jan 2019 MMC will have a second ID proofing option. Two draft documents were shared to explain the ID proofing changes. State Identity Proofing Request Process identifies the steps for ID proofing.  State Identity Proofing Request Form is the document used to finalize the secondary ID proofing steps. Please review these documents. If you have questions or input please let Paula Campbell, Associate Director of Marketplace Activities (pcampbell@iphca.org) know.   

Tools for Outreach

Marketplace 2018 Outreach Materials

One-Page Guide: A One-Page Guide to the Health Insurance Marketplace

Uninsured Outreach Mapping Tool 

User guide and Frequently Asked Questions. 

Tools to Help Consumers Use Their Health Coverage

Tools to Help Consumers Use Their Health Coverage

 

  • From Coverage to Care"  toolkit has printable booklets, resource pages, and educational videos all designed to help the consumer understand how to use their health coverage.

Tools for Assisting Enrollment

HFS Eligibility Checks within MEDI/REVS:

Please use one of the following four combinations to do eligibility checks within MEDI/REVS:

  •          Provider ID, Begin Date, End Date, and Recipient Number
  •          Provider ID, Begin Date, End Date, Social Security Number, and Date of Birth
  •          Provider ID, Begin Date, End Date, First Name, Last Name, and Date of Birth
  •          Provider ID, Begin Date, End Date, First Name, Last Name, and Social Security Number

**If you know the Recipient Number, use that.  **Do not to use the “County” field when the RIN is known.

 

  • Robert Wood Johnson Foundation Resource for Navigators
    Resource guide that helps navigators (or all assisters) answer questions about insurance reforms. Includes information on individuals with no coverage, individuals who currently have coverage or an offer of coverage from their employers, and coverage for small business owners.
  • Health Insurance Basics
    Information section on healthcare.gov that covers the basic element of the ACA and signing up for coverage.
  • Why Should I Have Health Coverage
    Includes a video and explains the importance of health insurance, how coverage works, etc.
  • Premium Estimates
    Not an application for the Marketplace. Provides an estimate calculator to determine what premiums might be for a consumer.
  • HRSA Outreach and Enrollment Technical Assistance 
    Resources provided by HRSA and BPHC (Bureau of Primary Health Care). Includes information about Technical Assistance (TA) calls, quarterly reports, recordings of previous calls etc.
  • CMS.gov    
    Main website for the Centers for Medicare and Medicaid Services. Information includes regulations and guidance, research, statistics, outreach and education, and more.
  • CMS Materials for O/E
    Materials can be ordered from CMS at no cost at this link. CACs are also able to download the materials and print in-house.

Special Enrollment Periods (SEP)

Fact Sheet: SEP for Discontinued 2017 Plans

People enrolled in 2017 Marketplace plans that are discontinued for 2018 are eligible for the special enrollment period (SEP) for people losing minimum essential coverage. People eligible for the loss of coverage SEP have 60 days before or 60 days after the date of their previous coverage ends to enroll in or change plans. For people whose 2017 plans are discontinued for 2018 that date is December 31, 2017.  SEP Discontinued 2017 Plan Fact Sheet 

SEP Reference Chart Updated June 2018

The Centers for Medicare & Medicaid Services (CMS) made several changes to special enrollment periods that took effect on June 18. To reflect these changes, Beyond the Basics has updated their Special Enrollment Period Reference Chart.  SEP Reference Chart

Changes include:

  • SEP for loss of pregnancy-related coverage provided through CHIP.  An SEP is now available for the loss of coverage provided through the Children’s Health Insurance Program (CHIP) “unborn child” option, which only covers pregnancy-related services and is not considered minimum essential coverage. 
  • Additional exemption from the prior coverage requirement for people living in bare counties. Some SEPs require that a person be enrolled in some form of minimum essential coverage for at least 1 day in the 60 days prior to experiencing a qualifying event. People who live in a service area with no plans sold in the Marketplace during the most recent available open or special enrollment period or during the 60 days prior to a qualifying event are exempt from this prior coverage requirement. 
  • Coverage effective date change for SEP for birth/adoption/placement in foster care/court order. People eligible for this SEP can now choose to begin new coverage on the first day of the month following plan selection (instead of the first day of the month following the birth/adoption/placement in foster care/court order). 

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500 S. Ninth St., Springfield, IL 62701
(217) 541-7300


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(312) 692-3000


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