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JILL HANKEN ENROLL VIRGINIA! VIRGINIA POVERTY LAW CENTER OCTOBER 5, 2015 KNOW YOUR PARTNERS! PREPARING FOR OE3 919 E Main St. Suite 610, Richmond, VA 23219.

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Presentation on theme: "JILL HANKEN ENROLL VIRGINIA! VIRGINIA POVERTY LAW CENTER OCTOBER 5, 2015 KNOW YOUR PARTNERS! PREPARING FOR OE3 919 E Main St. Suite 610, Richmond, VA 23219."— Presentation transcript:

1 JILL HANKEN ENROLL VIRGINIA! VIRGINIA POVERTY LAW CENTER OCTOBER 5, 2015 KNOW YOUR PARTNERS! PREPARING FOR OE3 919 E Main St. Suite 610, Richmond, VA 23219 T: 804-782-9430 F: 804-649-0974

2 ENROLL VIRGINIA! Navigators -  8 legal aid programs  Young Invincibles  Funding for 25 certified navigators  3-year funding possible

3 ENROLL VIRGINIA! In-Person-Assisters  8 legal aid programs  Young Invincibles  Northern Virginia Family Services  Planned Parenthood (Richmond, Va. Beach)  Neighbors Keeper  Public Defender (Arlington, Alexandria)  Funding for 36 IPAs  Funding ends 02/29/2016

4 ENROLL VIRGINIA! Community Health Education Specialists  8 legal aid programs  Young Invincibles  Northern Virginia Family Services  Funding for 21 CHEPS  Funding ends 01/30/2016

5 New Navigator Grantees in Virginia Wellmont Foundation  SW Virginia  Non-profit health system  Five acute care hospitals, one critical access hospital, and over 100 healthcare facilities  [also navigator grantee in Tennessee] Boat People SOS  Northern Virginia  Vietnamese/Asian  [also navigator grantee in Georgia since 2013]

6 Virginia Association of Community Health Centers 72 IPAs at 27 federally qualified health centers 8 IPAs at community partners (free clinics, AHEC, Rural Health Ass’n)

7 CERTIFIED APPLICATION COUNSELORS (CACS) No direct funding from CMS Certified Programs/Organizations- providers, hospitals, health centers, churches, gov’t agency, community organizations, etc. 250+ at FQHCs  Organization applies on www.healthcare.govwww.healthcare.gov  Employ CACs, volunteer CACS  Each CAC must complete federal training to be certified (5 hours)

8 PROJECT CONNECT Children’s health insurance outreach since 1999. Directed by Virginia Health Care Foundation DMAS, federal & private funding 16.5 Outreach workers serve 29 localities Support through  Tool Kit  SignUpNow training (9,500 participants)  On-Demand, Online Training  Quarterly Newsletter (to 2,100 people/organizations)

9 Enroll Virginia Accomplishments Outreach events: 3,500+ Consumers Reached (not including mass marketing efforts): 100,000+ Applications: 5,800 Enrollments: 5,000 WELL DONE!!!

10 VIRGINIA ACCOMPLISHMENTS Marketplace enrollment  216,000 OE1  385,000 OE2  335,033 “effectuated enrollment” March 2015  Mostly new enrollees  85% with premium tax credits  56% with cost-sharing reduction  Average premium tax credit = $258/mo  Birth to age 34 – 40% Medicaid / FAMIS  Total enrollment up by only 7,600 since 2013 (.82%)  [Compare WV (Medicaid expanded) 172,000 enrolled (49%)]

11 CHALLENGES Lack of Medicaid Expansion in Virginia  30 states, including D.C. have expanded  400,000 potentially eligible in Virginia – working families  200,000 in gap – not Medicaid eligible; income under 100% FPL  Forfeiting federal funding – over $2+ billion already  Foregoing state savings – indigent care, CSBs, corrections, health department programs Complexities in policy  MAGI  Family Glitch  Required documentation, resolving inconsistencies  Tax Issues – penalty, exemptions, reconciliation

12 CHALLENGES While MAJOR improvements in federal Marketplace systems, problems remain  FFM transfers (in both directions)  Systems lag when implementing new policies  Consumer transitions (from/to Medicaid-FAMIS-Medicare- marketplace-employer coverage)  Communications between FFM and Plans  State system delays and backlogs

13 PLANS FOR OE3 Shorter FFM open enrollment – 11/01/2015 – 01/31/2016 All groups will identify and target underserved populations and communities Improve coordination/collaboration. Old & New Partners  Department of Social Services  Employment Commission  VICAP (at your Area Agency on Aging)  Rapid Response  ADAPT  Local Media – TV, Radio, Newspapers  Email & Social Media

14 Key Messages It’s time to get covered  Accidents happen, and medical bills can add up. Insurance protects you and your family. Financial help is available [Compare & save- you could save money by switching plans]  Most people can find health plans for $75 or less per month  If you choose not to buy health insurance in 2016, you may need to pay a fine of $695 or more in your taxes Getting covered is easier than ever [It’s easy to renew] Free help is available

15 Research Shows Deadlines motivate Tax penalties motivate In person assistance & multiple “touches” work Reaching eligible but uninsured:  60% know little about APTC  70% think/decide insurance is too expensive  50% haven’t been to marketplace  50% are young adults  90% of 18-24 year olds trust info on social media  80% would share health info via social media

16 Administrative Topics Training & Navigator Registration Conflicts of Interest  No direct/indirect consideration from health insurance (or stop loss) issuer in connection with enrollment  Must provide consumers information about full range of options  Must disclose  Any other type of insurance you intend to sell  Existing/former employment relations with health insurers (5 yrs)  Existing employment of spouse/domestic partner  Any existing or anticipated financial, business or contractual relationships with health insurers

17 Administrative Topics Folders for Consumers  Consent Form – (must keep your copies for 6 years)  Information about Marketplace Account  Information about Enrollment & Notices  Other Story Collection – special consent forms  Happy Consumers  People in the Medicaid Gap Data Collection

18 Online Tools Team Website Connector Tool

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