Open Enrollment for 2018 HealthCare.gov plans runs from November 1 through December 15, 2017. Learn more about plans and pricing at http://bit.ly/2ilaVDH. Find a Navigator near you on our Find Local Help page.
Please join us for Marketplace updates and two webinar presentations on Friday, September 22 at 2:00 PM ET.
Our first presentation will provide an overview of COBRA and how it interacts with Marketplace coverage. COBRA provides consumers that lose their job-based health insurance coverage with the option to continue their group health coverage provided by their former employer’s group health plan, for limited periods of time under certain circumstances. The presentation will explain how to aid consumers in evaluating their health insurance options, including coverage through COBRA continuation. Please refer to this job aid during the presentation.
Our second presentation will be an in-depth walkthrough of the plan comparison tool on HealthCare.gov, as well as the plan selection portion of the Marketplace application process. Please refer to this job aid during the presentation.
Who Should Attend:
Navigators, enrollment assistance personnel, and certified application counselors (CACs).
Friday, September 22 from 2:00 PM to 3:30 PM ET
To facilitate a quicker registration process on the day of the event, please register for the session by visiting the following link: https://goto.webcasts.com/
Space is limited – we strongly encourage individuals from the same organization to gather in a common room and participate as a group using a single computer.
Connect with HealthCare.gov for the latest information on Open Enrollment. Click here to learn more.
The Centers for Medicare & Medicaid Services (CMS) announced on Thursday new policies related to the Navigator program and enrollment education for the upcoming Health Insurance Marketplace open enrollment period.
For the upcoming enrollment period, Navigator grantees will receive funding based on their ability to meet their enrollment goals during the previous year. For example, a grantee that achieved 100 percent or more of its enrollment goal for plan year 2017 will receive the same level of funding as last year. CMS said, “these performance-based adjustments will ensure accountability within the Navigator program and avoid rewarding grantees that have failed to meet their performance measures.”
The ACA established the Navigator program to help facilitate consumer education and enrollment. Funding for the Navigator program and open enrollment promotional activities comes from user fees paid by issuers who are participating in the FFE.
CMS plans to spend $10 million on promotional activities in order to meet the needs of new or returning ACA enrollees – consistent with promotional spending on Medicare Advantage and Medicare Part D. CMS will target its advertising and outreach activities to educate consumers on the new dates of the Open Enrollment Period through digital media, email, and text messages. These outreach methodologies have proven the most effective in reaching existing and new enrollees.
Open enrollment on HealthCare.gov will run from November 1, 2017 to December 15, 2017, for plans with a start date after January 1, 2018.
Enroll Michigan will provide additional updates as more information becomes available.
CMS recently released a bulletin detailing information about Health Insurance Marketplace training for Navigators and Certified Application Counselors (CAC) assisting with the 2018 plan year coverage options.
The training includes a refresher course plus the following required courses: “Privacy, Security, and Fraud Prevention Standards,” “Coverage to Care Assistance,” and “Assister Standard Operating Procedures.” The training also includes virtual simulations that illustrate the Marketplace application and enrollment process on HealthCare.gov. All of the training can be completed online through the Marketplace Learning Management System (MLMS).
CMS estimates that the training for a Navigator will take about 20 hours and the training for a CAC will take 5 to 10 hours to complete. You can read the entire bulletin here.
Enroll Michigan will issue further guidance soon for our network of Navigators.
Have questions about the Health Insurance Marketplace? Check out their blog post at http://bit.ly/2u3GNp9.
FYI: HealthCare.gov open enrollment begins earlier for 2018.
From the July CMS Assister Update:
Key Takeaway: Under the recently finalized Marketplace Stabilization Rule, as of June 23, 2017, a health plan issuer may apply any payments a consumer makes for new coverage (a binder payment) with that issuertowards past-due premiums owed to that issuer. The issuer may also refuse to effectuate the new coverage if the consumer fails to pay past-due premiums owed from the 12-month period preceding the effective date of new coverage.
It is very important for assisters to help consumers understand the consequences of non-payment of premiums. Previously, issuers were prohibited from applying a binder payment to past-due premiums and issuers were required to effectuate the consumer’s new enrollment under the guaranteed availability rules. As of June 23rd issuers may apply the binder payment to an individual’s past debt to that issuer, from the 12 months preceding the effective date of new coverage, before applying the payment toward a new enrollment. The individual, however, must be provided notice of the issuer’s binder payment policy before the binder payment can be applied to the past debt.
For example, Claire was covered with Issuer A and stopped making payments in July 2017. Claire was receiving Advanced Payments of Premium Tax Credit (APTCs), so after her three month grace period, Issuer A terminated Claire’s coverage in October. In November, Claire would like to come back to the Marketplace during open enrollment to seek 2018 coverage. Claire enrolls with Issuer A and makes her binder payment. Under these new rules, Issuer A can apply Claire’s 2018 binder payment towards her debt owed to Issuer A and choose not to effectuate her 2018 coverage, unless Claire pays all her past-due premiums. Claire must pay the outstanding premium debt before the end of open enrollment for 2018, in addition to the 2018 binder payment, in order to enroll with Issuer A for 2018 coverage.
Here are some important tips for assisters:
 This includes any issuer in the issuer’s controlled group. A controlled group means a group of two or more corporations that are treated as a single employer under sections 52(a), 52(b), 414(m), or 414(o) of the Internal Revenue Code of 1986, as amended, or a narrower group as may be provided by applicable State law.
 “Past-due premiums’’ refers to premiums that have not been paid by the applicable due date as established by the issuer in accordance with applicable Federal and State law. It does not include premiums for months in which individuals were not enrolled in coverage.
 Only the individual who is contractually obligated to make the payment would have his or her new coverage effectuation conditioned on past-due premiums. Dependents under the prior 12-month period of coverage could purchase new coverage for themselves from the issuer (or issuer’s controlled group), without paying past-due premiums.
Enroll Michigan has divided our state into 10 regions to make sure there is a Navigator Agency nearby to assist you at no cost. To find a navigator agency near you, just identify what region you live in using the map and then review the navigator agencies listed as serving your region of the state. The “Regional Lead” staff person for your part of the state is also