Arming Navigators with the Right Information to Help Enroll People in Coverage

With the fast approach to open enrollment for the new Health Insurance Marketplaces starting October 1st, there is growing interest in the Navigators and other assisters who will help people learn about their coverage options and get enrolled.  Navigators will have to be able to provide information on private health insurance, both for individuals and small businesses, public programs, and insurance affordability programs, including premium tax credits and cost sharing reductions. States operating their own Marketplaces will run their own Navigator and In-Person Assister Programs. In Federally Facilitated Marketplaces, HHS will operate the Navigator programs and provide training to the Navigators selected through a federal grant program.

We here at CHIR will be adding to the private insurance knowledge and support for Navigators and assisters of all types, both formal and informal. With funding from the Robert Wood Johnson Foundation, CHIR will develop a quick reference guide on private health insurance and the reforms of the ACA. The guide will be designed as an assister resource as consumers raise questions about their health insurance rights and options when they contact Navigators and others.  This resource will:

  • complement the high-level Navigator training materials being developed by federal regulators;
  • indicate for readers instances in which there may be differences in state laws or rules, so that community based organizations and other groups supporting assisters can tailor the reference guide to reflect the rules of their own state; and
  •  include Frequently Asked Questions that will be updated to reflect the issues and questions that emerge as Navigators and assisters begin their outreach and enrollment work.

Our work will also include providing technical assistance to groups supporting assisters in up to 5 states. We will provide “back-office support” to assisters in those states when they get complicated consumer issues or questions. We expect Navigators and assisters will have the training to handle most consumer questions that arise, but there’s likely to be complicated issues that may require more in-depth  research and working with state and federal regulators to answer in a definitive way. The questions we field as part of our TA work can help inform updates to the guide and FAQs.

We hope this resource can be shared broadly – watch for it on our website as we near October 1 – and we’ll report back here at CHIRblog on what we’re learning from the Navigators and assisters we work with in those 5 states. There’s enough work to do to get those 7 million people enrolled in year 1, so we hope to help the folks making that possible learn in real time from their peers.

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