Transcription of “Member Transition Conference Call” recording.
I want to welcome everyone to the “Member Transition Conference Call” this afternoon. Thank you for your interest in today’s call.
I’m Debbie Raymond from the Massachusetts Health Care Training Forum Teamand I will be facilitating today’s call. Our presenters are:
• Carolyn Pitzi, Director of Outreach and Education for the Office of Medicaid and
• Niki Conte, Associate Director of Public Outreach and Education for the Health Connector Joining us during the Q&A Session will be:
• Howard Caplan, Director of ACA/HIX Communications/Training/Outreach for the Office of Medicaid and
• Nick McNeil, Senior Product Analyst for the Health Connector
We have a very large number of callers on the line and want to hear from as many of you possible during the Q&A session after the presentation. We ask that you please limit questions to one per phone line. If we do not get to your question you will have the opportunity to ask it in our post survey evaluation which will be emailed to you after today’s call. We will make every effort to incorporate your questions into our FAQ sheet post them on to the MTF website.
Just some quick housekeeping
1) This session is being recorded.
2) The recording will be posted on the MTF website.
3) Please DO NOT disclose any personal information or protected health information if you participate in the question and answer portion of this call.
4) To optimize your listening experience, “all phone lines have been placed on Mute.” Please do not put your phone on hold at any time during this call. Your hold music will ruin the call for others. When it is time for questions and answers, I will explain how to chime in and get into the queue for
And at this point I’d like to turn it over to our presenters Carolyn and Niki. (Speaker: Carolyn Pitzi)
Good afternoon everybody we’re happy to be here today and provide you details about the upcoming Member Transition as a result of the Affordable Care Act (ACA). We have a lot of material today so bear with us. Some of these slides are here more for a resource for you, some of the slides we’re going to spend less time on. We are excited to be able to share with you some samples of specific communications that are going out so we’d like to take a little bit more time on those areas. With that said why don’t we go ahead and get started.
Slide 2
On slide two as you can see (for folks that may be new to this call) – MassHealth and the Health Connector have been rolling out an Affordable Care Act series dating back from January 2012. As we go up to
implementation date – January 1st, 2014 we’ve been engaging with all of you who work with our current Commonwealth Care, Commonwealth Choice, MassHealth and Health Safety Net (HSN) members to make sure that you understand the key concepts as well as, now that we are getting very close to October 1st, more details about the new programs and plans that will be available and policies and eligibility enrollment
procedures around those. Slide 3 and Slide 4
Slide three and four are guiding principles that serve as a baseline for Executive Office of Health and Human Services (EOHHS), MassHealth and the Health Connector as we undertake ACA implementation – that’s just a resource for you all.
Slide 5
Slide five is today’s agenda talking about how ACA in fact streamlines coverage where we have actually less health care programs as a result of ACA, broader coverage for uninsured, but less coverage types so that’s good news. We’ll talk a little bit about open enrollment. Much more details about specific member transition plans and share with you about outreach, education and communication resources.
As a result of the Affordable Care Act many of the programs that we’ve been able to build over the years are now actually going to be going away. We want to highlight some of those which are MassHealth Basic, MassHealth Essential, Medical Security Plan (MSP), Commonwealth Care and the Insurance Partnership (IP) will be discontinued come January 1st, 2014. All members in those programs will be transitioned to similar or richer benefits as they are today as a result of the ACA.
Slide 7
Looking at slide seven you can see the new coverage constructs that will be in place come January 1st. For MassHealth the coverage types have slimed down. We’ve actually added a couple of new types – you’ll see
MassHealth Standard, CommonHealth, MassHealth CarePlus, which is new, Family Assistance, Small Business Employee Premium Assistance, which is also a new coverage type, MassHealth Limited and Children’s Medical Security Plan.
The Health Connector will now offer qualified health plans come January 1st, some of which will include premium tax credits and also Connector Care plans that offer premium tax credits and cost sharing subsidies depending on folks’ incomes. Also the Health Safety Net – will very much be available.
(Speaker: Niki Conte) Slide 8
Starting on slide eight we want to reinforce that it’s really a priority for both of our organizations – Health Connector and MassHealth to help ensure a seamless transition as these new coverage types become
available through the Affordable Care Act. Carolyn hit on this a little bit but I just want to reinforce that there will be some individuals who are going to need to reapply to obtain the new coverage while there will be other folks who will not need to take action. You’re going to hear the two of us many times throughout this
presentation today remind you who will actually need to take action and which folks will not.
Let’s start with those who aren’t required to reapply, certain Commonwealth Care members with incomes under 133% Federal Poverty Level (FPL), people in MassHealth, and those receiving services paid for by the Health Safety Net. If we have eligibility information about those folks already in our system it will be used to help place people into a new MassHealth Benefit plan. We’ll be able to send them a notice that will indicate if they are eligible for the new Medicaid program and again they will not need to reapply.
For current Commonwealth Choice, Commonwealth Care, some folks in the Insurance Partnership, Children’s Medical Security Program (CMSP), Health Safety Net and all the folks in the Medical Security Program – those members may now qualify for a Qualified Health Plan (QHP), and they’re going to be directed through various communications to reapply or apply for new health coverage options through MAhealthconnector.org. Some of the reasons behind having those folks need to reapply are that eligibility is actually going to be determined a little bit differently. We are going to be using Modified Adjusted Gross Income (MAGI) to determine whether or not folks are in fact eligible for these new coverage programs so again folks will need to reapply and provide information, then the system will determine where they fall. We’ll talk much more about different types of outreach activities that we intend to use to help move folks into new coverage programs and coverage plans.
Slide 9
On slide nine the visual really reinforces what I just said, what Carolyn had previously said, on the Health Connector side we’ve identified these groups as being potentially eligible for a Qualified Health Plan. We have focused a lot of our efforts on the subsidized population – Commonwealth Care, but I want to communicate that it is really important that folks out there who are currently getting coverage through Commonwealth
Choice are made aware that new options are available through the Health Connector and potential subsidies are available to them so, all of our Commonwealth Choice folks will need to reapply and I’ll get into that in further detail later.
Commonwealth Care members with incomes over 133% FPL as well as those Commonwealth Care members who are known to us as Aliens with Special Status (AWSS) or who are lawfully present with incomes between 0 to 300% FPL are going to need to reapply, they will be staying with the Health Connector. Other folks who are going to land at the Health Connector in a QHP include Insurance Partnership, HSN, CMSP and those folks who are in Medical Security Programs. On the MassHealth side they’re going to be transitioning populations that are going into MassHealth. So those individuals with incomes less than or equal to 133% FPL as well as certain individuals who are 19 to 20 years old who have incomes less than 150% FPL. So who are those folks? Those are Commonwealth Care members, the folks in MassHealth Essential, MassHealth Basic, MassHealth Family Assistance for HIV, Insurance Partnership, and HSN.
Slide 10
On slide 10 we’re looking at federal open enrollment dates specifically for non-group. And we’ve labeled this in this way for a very specific reason. For those on the phone who are very used to working with our
Commonwealth Care population, you know that Commonwealth Care members are used to open enrollment meaning one particular thing. Our Commonwealth Choice members are also used to an open enrollment time frame relative to commercial products. However, we now have a new federal open enrollment and for this year that open enrollment period is October 1, 2013 through March 31st, 2014. For those who are interested in getting coverage effective for January 1, we’re asking that folks, who need to take action, do so following October 1 and take action, and complete their activity prior to December 31st of 2013 for coverage for January 1. Again, we’re going to keep reinforcing this message but this is really important for folks to understand who needs to take action during this time and who does not.
(Speaker: Carolyn Pitzi) Slide 11
Niki, that’s a good segue to slide 11 and open enrollment and how that intersects or affects MassHealth. We want to be clear that, by and large, most of the changes to MassHealth programs are going into effect January 1st, 2014 and most of our beneficiaries will actually not be impacted by ACA. However for individuals that will be experiencing transition we’re going to go ahead and do that kind of behind the scenes where we’re automatically transitioning folks. But basically what you’re seeing on slide 11 is saying for folks who need immediate MassHealth coverage, we just need those to go ahead and use the process that they use today, which is either paper process or Virtual Gateway and that’s basically from October to mid-December. Open enrollment, what Niki has highlighted, is primarily for those folks who are going to be QHP potentially eligible. We did want to point out that there are some families that are kind of called mixed households, where they may be either on a Health Connector program, for example Commonwealth Care, and have somebody in the household that also has MassHealth, for those individuals they will be receiving
communications that explain that they need to go ahead and make sure that that whole family needs to reapply when they apply for coverage.
(Speaker: Nicki Conte) Slide 13
I’m going to pick it up from here and talk a little bit about member transition. You can imagine both of our organizations are each working on different types of member transition plans but I want to get into, on slide 13, very specifically how the Affordable Care Act affects Commonwealth Care. As we said, Commonwealth Care is going away as of December 31st. For current members with incomes above 133% FPL and those who are lawfully present Aliens with Special Status (AWSS) with incomes from 0 to 300% FPL who may qualify for a QHP will be directed to reapply, enroll, and submit their first payment through the Health Connector website at mahealthconnector.org. They can also complete these processes by phone at the number listed here, (877) 623-6765. The key date for a January 1 effective date is December 23rd. We’ve mentioned already that
eligibility is being determined a little bit differently, we’re using Modified Adjusted Gross Income. There are going to be different efforts to reach each of these folks. Now, again one more time, there are some folks who will not need to take action. Some of our current members, those who have an AWSS status as well as those who are between 19yrs and 20yrs old, at or below 150% FPL, will be placed in a MassHealth benefit plan. Again, if somebody is eligible for a Medicaid program, they will, in fact, get that information coming to them from MassHealth.
Slide 14
On slide 14, I want to jump to the Commonwealth Choice program. The dates around this program ending, are a little bit different than Commonwealth Care. Individual members must transition by their renewal date during Federal Open Enrollment period which ends on March 31st. There are also very specific programs within Commonwealth Choice that are changing. So right now in Commonwealth Choice we have a program for young adults, or young adult plans. That program is ending on December 31st. Any members who are seeking coverage must reapply, enroll, and submit their first payment for new plans by December 23rd for January 1 effective date.
We also have our small group members whose transition is a little bit different. Small group members are going to transition by their renewal date during 2014 and they’re going to do this on a rolling basis depending on when their plan ends. There are a couple of notes at the bottom of this page that I just want to ensure that folks pay special attention to. Because of different changes and rules, according to the Affordable Care Act, those small businesses who are sole proprietors will not be eligible to enroll in small group products. In order to maintain coverage they must enroll in a Non-Group Qualified Health Plan by March 31st. Also we have folks in voluntary plans that will not be offered plans for the Marketplace under the ACA and they’ll need to explore other options as well.
(Speaker: Carolyn Pitzi) Slide 15
I’m just going to turn folks to slide 15 and some of this was actually already covered so just to reiterate
MassHealth current case load is about 1.3 million members and of that caseload most of the members will not be experiencing a change as a result of the Affordable Care Act, however for those who are changing we’re working very closely – side by side with the Connector on collaborating to make this transition as smooth as possible. As Niki had mentioned already we’re going to go ahead and use existing information in our eligibility system to seamlessly transition folks. To quote – map folks – to new coverage. They won’t have to reapply. They’ll just be automatically transitioned. Again as you can see on the fourth dot point that they do not need to reapply.
What folks may need to do for people who are in MassHealth Basic or Essential, Commonwealth Care, Insurance Partnership or HSN – they will be getting communications to tell them of their new coverage type and that they will at that point in time be instructed with next steps, which would include choosing a new health plan. We did want to mention that Medical Security Program folks will need to reapply to find out if they qualify for MassHealth.
Slide 16
On slide 16 I just want to talk about who are some of these folks that are transitioning. Childless Adults age 21 to 64 who are primarily in Commonwealth Care right now will be transitioning to MassHealth CarePlus. We also have some individuals who have special health care needs that will be eligible for MassHealth Standard. There are some other transitioning folks that are 19 to 20 year olds with incomes at or under 150% FPL who will be eligible now as a result of the Affordable Care Act for MassHealth Standard – that also includes lawfully present immigrants. As we mentioned previously MassHealth Basic and Essential, Commonwealth Care and Insurance Partnership as well as HSN – folks under 133% FPL will be transitioning to MassHealth Coverage. I think you guys are getting the message, they do not need to reapply, they will be automatically transitioned. Slide 17
Taking a closer look on slide 17 around Insurance Partnership – as folks may know Insurance Partnership right now provides help with insurance premiums for small businesses and their low-income employees. As of January 1st Insurance Partnership will be discontinued. As a result of this some small employers will have new opportunities to shop for health coverage through the Affordable Care Act and that they may qualify for federal tax credits. Employees who have participated in Insurance Partnership may qualify for MassHealth coverage or Health Connector coverage, depending on their income.
Slide 18
On Slide 18 just a little bit more about the Insurance Partnership. We’re working side by side with the Connector to make sure that communications go out to current IP enrollees. Some of these IP folks may qualify as I mentioned for MassHealth including the new MassHealth coverage type, Small Business Premium Assistance program. Again, they do not need to reapply. Members who may qualify for Health Connector, including Connector Care plans, will need to reapply. We’re working side by side on these outreach efforts and we actually have a dedicated customer service line at Mass Health for Insurance Partnership members.
Slide 19
We also wanted, on slide 19, to talk a little bit more about the Children’s Medical Security plan. As folks may know, Children’s Medical Security Plan currently provides coverage for children age 18 or younger who are not eligible for any other MassHealth program. There’s no income limit for this but there are sliding scale
premiums. As a result of the Affordable Care Act, CMSP will still be available for these kids, to provide a safety net of coverage and their eligibility won’t change. However we did want to point out that with the new ACA provisions, CMSP actually doesn’t meet the test for comprehensive coverage and therefore parents would really need to pay attention and actually obtain more comprehensive coverage or they could be subject to a tax penalty. Those specific kids are children who are citizens or lawfully present immigrants. And, again, this is just to highlight that this is actually good news that they are now eligible for better benefits through the Health Connector and that they should apply during open enrolment and that they will receive
communications, specifically the open enrolment packet, that will give them the instructions on how to reapply.
Slide 20
On slide 20 we just want to spend a couple moments on Health Safety Net transition. As you probably all know the Health Safety Net is a process where it reimburses hospitals and community health centers for services provided to low income folks up to 400% FPL and that those folks are not eligible for MassHealth or
Commonwealth Connector programs. Now certain Health Safety Net members, as a result of the ACA, will now be eligible for more comprehensive coverage and they’ll be automatically transitioned to MassHealth. Other HSN members may also be eligible to get help paying for insurance through the Connector and as we’ve mentioned a few times in this call that they’ll be getting communications instructing them on how to apply for QHP coverage during open enrollment. We did want to note that if these individuals do nothing, that’s ok, they’ll stay in the HSN but just as in today’s world the HSN does not meet comprehensive coverage and therefore those individuals could be subject to a tax penalty.
Slide 21
Slide 21 is really just a quick snapshot to show you, as I mentioned before MassHealth covers approximately 1.3 million members, this is really to show you all of these groups in this chart will be experiencing no change as a result of the Affordable Care Act. They’re just going to go ahead and stay in Standard, CommonHealth, Family Assistance and that because of that they actually won’t be hearing from us because there’s no special ACA communication.
(Speaker: Niki Conte) Slide 22
With that I’m going to pick up on slide 22 and talk to you a little bit about our efforts around consumer outreach and education.
Slide 23
On slide 23 you’re seeing a visual on the different initiatives that we are currently undertaking related to outreach. Starting from the top I’m going to work my way around the right. You’ll notice an outbound calling campaign, a media campaign, public education efforts, roadshows, enrollment assistors, and direct mail and email. So all of these efforts are intended to complement one another and, sometimes, overlap one another and I’ll get into that in the next several slides but we just want to, again, reinforce that we’re aware of the fact that we need to be very consistent in our messaging and really we’re trying to use every communications channel that is available to our organizations to insure that we’re getting the word out about these upcoming changes.
Slide 24
On slide 24, you’re able to see a little bit more detail around each of these efforts and when they began, and how we’re intending to use them. I’m going to just give you a little bit of information about each of these efforts. I’m going to start with the outbound calling campaign and this is a really new effort. Since I’ve been here, and I’m checking with Carolyn as well, I don’t think that we’ve ever undertaken an effort like this and we’re really excited to go down this path and see how this works with our consumers. But starting in October actually we’re going to begin a series of outbound calls to those individuals who are known to us who we believe are eligible for QHPs and we know are losing coverage. These calls are going to be using a combination of methods. We’ll be using robocalls that complement other activities that are going on and as we get closer to the end of the calendar year, the number of messages that go out, the messages themselves, the urgency is going to increase, and the person will be able to connect to a live agent once they’ve received those calls to help them transition into a new plan.
The outbound calls really complement the direct mail and email that we’ve been sending to our members and we intend to send to members going all the way through open enrollment. Beginning last spring we started with our Commonwealth Care Open Enrollment Packet where we started to communicate that the program was changing, the program as they knew it was changing and there would be new offerings available through the ACA. We’ve connected our mailings to the mailing using postcards; you’ll see a sample of that, and we keep talking about this open enrollment packet and we promise we’ll show a sample of what that looks like and how we’re able to customize that.
The next section here talks about enrollment assistors. We are enlisting the services of Navigators, Certified Application Counselors, as well as our broker community to help us reach our members and help them help our member’s transition into new plans, so I will touch on that. Roadshows, actually we’re on the road right now, so I’ll tell you a little bit more about our small employer roadshows and what type of information folks can expect to get there as well as our PIU. When we had previously passed Chapter 58 in Massachusetts one of the outreach efforts that really worked well was the implementation of a Public Information Unit (PIU). As you can see we have a number of folks out in the field that will be able to assist members it’s really important
that we have a dedicated staff known as our Public Information Unit who can help field some of the really technical questions for Massachusetts consumers. PIU will not be enrolling members into health insurance plans but, again, they’re just going to be there as a technical resource.
Above all of this you’re going to be hearing from the Health Connector through our media campaign. You may have noticed that we’ve increased our presence to the social media sphere. Over the summer we actually launched a new micro site which has enabled us to share some outreach information with folks as well as more FAQs about the Affordable Care Act and we’re all planning for a new website launch, a new
mahealthconnector.org, available on 10/1, once open enrollment is open where individuals can begin to shop, apply, and enroll.
Slide 25
Let’s look at slide 25 for a moment. These roadshows are actually a series of “town hall” style public events and they’re intended to engage employers and brokers. These began this week on September 9th, and the events build on the foundation of our current employer engagement. We want to talk to employers of all sizes and promote the understanding of the Affordable Care Act and its impact on them. Some of the topics include reconciling Massachusetts reform and ACA reform, employer opportunities and responsibilities, as well as changes to subsidized coverage. On the left you’ll see the dates and locations if you have any contacts that are interested in attending any of these sessions.
Slide 26
On slide 26 you’re seeing examples of some public education collateral that is now available. There are different types of collateral. We have collateral that explains National Health Care Reform and what it might mean to a consumer as well as what the new health insurance marketplace, the new Health Connector, is offering people. There are some other pieces of collateral that start to get a little more technical and depending on the audience, we’ve got the guide for small businesses as well as the consumer guide. Again, these are available on the Health Connector website.
Slide 27
Now on slide 27. This is a sample of the open enrollment packet that both Carolyn and I have been referring to What’s really unique about this packet, and we wanted to make this large enough so that you were able to read the text, is that this is actual language that Commonwealth Care members with incomes above 133% FPL, and I want to make sure I get this out there very clearly, we’re also sending this out to both Aliens With Special Status with incomes starting at 0, anyone who could potentially be eligible for a QHP and will need to reapply. What’s important to know here is that we can customize, and we’re intending to customize, this letter. The opening couple of paragraphs for this letter will change depending on the audience. For example Carolyn spent a little bit more time talking about the CMSP population, the Insurance Partnership population, and this is how we’re using a similar packet but we’re able to customize the cover letter. We just wanted you to be very aware of what this looks like and what people may be coming into your office with.
On the next slide you’re seeing the inside panels to this packet. You’ve got more information, FAQs about open enrollment on the left and then some very important information about how to set up an online account and what kinds of materials somebody should think about pulling together if they’re about to do this on their own. I don’t know that we said this on this call, I know in other presentations we have, but we really are in a unique opportunity for consumers. They can now go in on their own and apply for health insurance coverage, and enroll on their own.
Slide 29
However, go to the next slide, we know that some folks will still need some assistance in going through this process. If someone needs help there are multiple channels that they can take advantage of to get assistance. For October 1 you’re seeing the MA Health Connector customer service number listed here. You’ll notice that we have extended hours during open enrollment. We have later evenings and Saturday hours as well as reference to Navigators and Certified Application Counselors. After October 1 we’re going to have a list of Navigators as well as those at hospitals and health centers who are now Certified Application Counselors. These are staff that will have been trained to help consumers through the application process. So we’ll, again, talk about that in more detail but wanted you to see the packet.
Slide 30
On the next slide you are seeing a sample of the branding postcard that went out to folks in August. This was actually sent in both English and in Spanish. You’re only seeing the English version here but, again, the intention here is to connect our new Health Connector logo with our existing logo. Just something to note from an operational perspective, as we go forward, there are some notices, there are some communications, that will still have the old logo so invoices for example, some eligibility notices will still have the old Health Connector logo, we just want you to help us alleviate any confusions for consumers.
(Speaker: Carolyn Pitzi) Slide 31
Great, and I’m just going to get folks to take a look at slide 31 related to MassHealth related communications to members. As I mentioned it’s a subset of our entire caseload, so it’s actually about 300,000 members that, as a result of the Affordable Care Act, will be experiencing a transition. MassHealth will be outreaching to members during the month of November, so it’s early November, and then they’ll be also hearing from us in again in December. Early November we’re giving what we’re calling like an in advance kind of heads up letter that will be explaining to them, you know, good news as a result of the Affordable Care Act you will be transitioning to this new coverage type. This is, again, informational only; they don’t need to take any action. We’re referencing this kind of thing known as the “pink letter”. Since MassHealth sends a lot of
communications we needed a way for customer service and for members to kind of easily be able to identify this particular communication. It will tell them their new coverage type that they’ll be getting and where to
In mid-December they will actually be receiving their official eligibility notice and that will be an appealable notice, it will say, “Welcome, you now have MassHealth CarePlus”, as an example. In that communication we will also include our new Mass Health member booklet as well as the appropriate health plan enrollment guide. For CarePlus we will have a standalone enrollment guide and then for Standard and our other coverage types it’s our regular enrollment guide. And the reason that will be included is because folks will be instructed, it says, “This is your new coverage type. We need you to go ahead and select a plan.” And those specific instructions will be included in the eligibility notice. As I mentioned before, the folks, the other kind of subset of our population that aren’t getting any change in coverage, we’re not going to go ahead and send them any communications because we honestly thought it would just be a little bit confusing for them when nothing’s changing for them.
Slide 32
On slide 32, a little bit of a recap and I don’t want to spend too much time on this, but just to make sure folks are aware on the MassHealth website we actually do have, you go right onto mass.gov/masshealth, a web link that’s kind of front and center that talks about ACA, includes information about the Health Insurance
Exchange (HIX), it’s also very soon going to be having specific FAQs that actually are very detailed about the transition that Niki and I just covered. You all know about the MTF, you’re participating on this call. We’re eager to see you in October where we’ll be rolling out more information at the in person meetings. We’ve also been doing quite a bit of presentations to different trade groups and associations. Last couple of documents that I did want to flag for folks are that the MassHealth publications, Appendix Y, are in the process of being updated. This is, I guess, the EVS messages that show up on the POSC, these are the restricted messages for providers, those are appropriately being updated to ensure that ACA coverage information is included. We also wanted to share with you something we’re really excited about that was actually requested to us by consumer advocate groups, is an ACA Transition Toolkit that we’re working very closely with the Connector on. This will be in many ways almost like a detailed, easy-to-follow spreadsheet where it shows somebody in a certain coverage type, so as example somebody who is in Essential today, what their immigration status is that they’re FPL what will be their future coverage and do they need to take action... all in one handy, document, so we’re excited about that and that will be posted online, so stay tuned.
Slide 33
In terms of other communications on slide 33 really just wanted to reiterate some of the VG work that’s underway, the informational series, dedicated website as well as a conversational series that are happening weekly with the VG supervisors and managers and of course the outreach happening at MTF as well as a process for new types of organizations that are interested in becoming CACs.
(Speaker: Niki Conti) Slide 35
With that, I am going to jump right into the application process, so I think folks have heard of talk about who needs to reapply, who not need to reapply, but there will always be other individuals, other consumers who
may not be known to us and may need coverage, so what we have done, our organizations have worked together to create a what is known as Modal Window. This is the temporary screen that will be on the Health Connector website through December 31st. What will this do is try to help filter consumers to the right
location depending on the type of the health insurance coverage that they are seeking. You’ll notice on the left column there’s the new Health Connector logo. What we are trying to do there is steer consumers who are interested in applying for health insurance that starts in January 1, we’re trying to steer them down that path, so they can learn more about new health plans and they can really start to go in, shop, apply and go down that path.
For folks who are seeking health coverage right away either through the Health Connector or MassHealth, we have a different path, so in the middle if someone, a consumer is looking to buy a health plan that starts November 1 or December 1 or make a payment on a current Choice or Commonwealth Care account or they need to manage a business express account, we’re asking them to go in the middle path. And on the right side, there will be some consumers out there, who are seeking immediate coverage either through MassHealth or Commonwealth Care, any subsidized coverage immediate, we want to send down this path. There are a couple of special things to note here, if you’re over age 65, we’re mentioning to folks they please complete a paper application or if folks want to manage their current account with MassHealth, we’re asking them to go down that path as well as we give them the telephone line for MassHealth. Carolyn is there anything else here that we want to highlight?
(Speaker: Carolyn Pitzi)
No, I think you have it all covered.
(Speaker: Niki Conte) Slide 36
I’ll bring your attention to slide 36 and I won’t get into this too deeply. Some folks may have seen this at other presentations. What this visual tries to do really is give you a comprehensive understanding of what is
available through this new system. You’ve heard of it as referenced as the HIX/IES (Health Insurance
Exchange/Integrated Eligibility and you’ve heard people talk about it as HIX and then you’re hearing us really now talk about just simply the Health Connector website, so once someone goes into pages beyond
informational pages, what could they really do? Consumers can expect to be able to get to a home page, be able to create an account, they can use a screener to determine what they could potentially be eligible for before they begin to apply. Consumers should be able to expect to complete an application and receive an eligibility determination. There will be plan helpers, they will be able to view and compare plans and be able to complete their enrollment and lastly related to this overall system, they’ll be some account management functionality, so this is again, this roadmap shows both functionality, which is really going to happen over several releases, so we shouldn’t expect to see all of it on October 1, but just know that the broader picture for the system has been laid out here.
(Speaker: Carolyn Pitzi) Slide 37
I am going to just go ahead and turn folks to Slide 37 regarding the paper application. We all wanted to let you to know that as a result of the Affordable Care Act, new paper application is coming together. We’re happy to report just went to the printers today and that will be available for you all very soon. It will also be posted online. We do want to point out just as Niki talked about the temporary screen that will be on the Connector website if somebody comes into your office or if somebody has questions what do they do.
For individuals seeking immediate coverage, so that’s coverage prior to January 1, they can go ahead and complete this new paper application that is soon to be released. They can also fill out the current MBR. The new application is going to have a sticker on the front page, which is on the next slide, but it’s important the instructions mention that they fill out the questions in Section 4 for immediate coverage. And really that’s because we need that information to make the right eligibility determination for Essential or Commonwealth Care.
In terms of the current MBR, actually we’re going to go ahead and folks can still submit that and we’re going to be able to process that through the end of the year. As of January 1 though, that’s going to be phased out. And that we really do need the new application going forward. If for some reason the MBR did come in after January 1st, we’re still going to go ahead and be able to use some of that information, but we absolutely will have to follow up to make sure we can make a MAGI eligibility determination.
Slide 38
On slide 38 we just wanted to share with you a mock-up of what’s going to be on the new paper application with the instructions. I’ve already covered this, but again it’s just alerting folks for immediate coverage that they really need to fill out the questions in part 4. For folks that are looking for January coverage, they can just go to the Health Connecter website, but they don’t really have to focus on Section 4.
(Speaker: Niki Conte) Slide 39
I am going to take us through the next couple of slides on enrollment assisters. I had alluded to this, but then again I want to give folks on the line some more specifics because I think you have an interest. I mentioned that we are going to be enlisting the assistance of Brokers, Certified Application Counselors and Navigators. Each of these groups has been working with us to get training.
The focus for Brokers is really the small group world. The first Navigator Program that we’re running just began. Organizations were selected and we have gone through a first phase of training. Certified Application Counselors (CACs) is a new term, new concept, new program, and it’s going to be very similar to a world that a number of you already know.
Slide 40
If you look at slide 40, I want to talk a little more about that and how the Health Connector and MassHealth has been working really closely to create a program that meets the needs of the ACA and still leverages MassHealth’s long-standing relationship with providers through the Virtual Gateway Program.
In an effort to get this program up and running very quickly, we have been collaborating with provider organizations and trade associations to get feedback on Affordable Care requirements and develop a
comprehensive training and certification approach to meet our needs for 10/1. This is a multi-phase approach where the initial focus is going to be on a subset of hospitals and health centers that are going to be trained and certified prior to 10/1.
There’s going to be additional training and certification past 10/1 before 12/15 to get more individuals and organizations in as Certified Application Counselors. All organizations who are interested in becoming a Certified Application Counselor Organization will be designated as such prior to January 1, 2014. Agreements were sent out to an initial group on Wednesday September 4th.
In terms of the requirements for becoming a CAC Organization if you will, the organization must first sign an agreement. They are then going to need to designate a Lead Certified Counselor Trainer for their organization. That person is going to have responsibilities at the organization to ensure that they attend initial training, any ongoing Health Connector and MassHealth training and then go back to their respective organizations and train organization staff. All of this information has been recently communicated.
I’ll get right into the specific dates. Dedicated training for folks is happening Friday, September 13th as well as more training on September 17th and October 3rd. We’re using a mixed method of training these folks. We’re taking advantage of a full-day of conference call trainings on September 13th. On September 17th, we’re going to have a full-day of in-person system training for folks who are Navigators as well as Certified Application Counselors. October 3rd we’re going to have a two-hour webinar that is required for folks, to act as an
additional method of delivering training not only for these Lead Trainers as well as staff from their respective organization. It’s important for me to note that additional support in training and information is going to be given to these folks and to other organizations through the standing infrastructure, the Massachusetts Health Care Training Forum, so just like you received information about this call today, we’re asking that you please pay close attention to additional email messages from MTF.
(Speaker: Carolyn Pitzi) Slide 42
On 42, you’re going to see the process for immediate coverage. So some of you may be asking, what do we do? If somebody comes in, they want immediate coverage, it is business as usual. I think we’ve covered this at MTF so far, but basically the options are the Virtual Gateway Common Intake application, the existing MBR and the new paper application I had just talked about with our sticker on the front answering question 4. We do want to let people know that folks who want immediate coverage, we do not want them to go through the
Slide 43
On slide 43 for individuals seeking coverage January 1st or later, we really want to ensure that if at all possible folks use the MA Health Connector website either on their own or get assistance through an Enrollment Assistor: either a Navigator or Certified Application Counselor. Folks could also use new paper application and just to reiterate that if an MBR came in after January 1st, that would be ok, but not ideal, cause we would have to follow up to get the appropriate MAGI information. We also want to highlight that folks could call customer service to get assistance with completing an application.
Slide 44
Slide 44 is something that we actually already covered. It’s just more a resource for you on where folks can get help.
Slide 45
Slide 45 shows particular websites that we wanted to flag for you all on where you can get the latest and greatest about ACA.
(Speaker: Debbie Raymond) I want to thank our presenters Carolyn Pitzi and Niki Conte and thank you for joining us today. Have a great day. Bye.
