Health care reform
Open enrollment on the public Health Insurance Exchanges is scheduled to begin October 1, 2013. The government has taken several steps to help inform employers and individuals about the exchanges – now called Health Insurance Marketplaces.
The Department of Health and Human Services (HHS) has revamped its healthcare.gov site to walk individuals through the process of evaluating, choosing and enrolling in marketplace (formerly called “exchange”) plans. On this site, individuals can learn about the plans available to them, use a cost-subsidy calculator to help them figure costs, and set up an account that they can use to enroll on or after October 1. Employers who have employees that may meet the eligibility requirements for subsidies now have an easy-to-use information source to which they can direct their workers.
In addition, HHS has launched a new site to help educate employers about health care reform and how it will affect their businesses. A joint project of HHS, the Small Business Administration and the IRS, the site — Business.USA.gov/healthcare — provides information on coverage options, tax credits and other aspects of the health care reform law. It also includes a “wizard” that uses the company’s size and location to tailor information.1
In August 2013, the government announced $67 million in grants for Navigators, a resource for helping people understand and enroll for coverage on the marketplaces. These grants were awarded to 105 groups operating in states with federally facilitated marketplaces. In addition, the government relaxed its Navigator training requirements to help increase the pool of Navigators who would be ready for October’s open enrollment. Navigators must now complete 20 hours of training instead of 30. The administration has said that this change will not affect the Navigators’ ability to perform their functions, and that refresher training will be offered throughout the first six-month open enrollment period.2,3
Under the health care reform law, the Navigator role is designed to:
According to a new statement from the Centers for Medicare & Medicaid Services (CMS), Navigators will be paid $20 to $48 per hour, depending on their level, and should spend about an hour with each client, including 10 minutes for paperwork.4
A new role — Certified Application Counselor (CAC) — has been created to help individuals enroll through the marketplace. With a narrower mission than the Navigators, these counselors will provide information to individual consumers and help them enroll in qualified health plans and insurance affordability programs. All marketplaces must have a certified application counselor program, although state-run marketplaces may institute their own processes.5
The marketplaces are intended to make it easier for employees to access and compare health insurance policy information. As enrollment draws near, HHS is providing businesses and individuals with the resources — both on the web and in person — they will need to understand and enroll for coverage on the marketplaces.
HHS is providing businesses with the resources they will need to understand the marketplaces. In addition, employers will be able to send their employees to the HHS website to get information and set up their accounts — as well as direct them to Navigators and certified application counselors for assistance.