To: Hospital and System Public Relations Staff; Outreach and Enrollment Leaders
From: Mary Kay Clunies-Ross, VP Communications & Public Affairs
Zosia Stanley, Policy Director, Access
Staff Contact: Mary Kay Clunies-Ross, marykaycr@wsha.org, 206/216-2894
Subject: Update on Outreach and Enrollment
Purpose
This year’s open enrollment period will close on February 15, 2015. While Medicaid-eligible patients will still be able to use www.wahealthplanfinder.org to enroll in AppleHealth, most of the people enrolling in commercial insurance will lose their opportunity until the next open enrollment period.
Applicability/Scope
Almost all hospitals have been helping patients and family members to get enrolled.
Recommendation
Hospitals and health systems are urged to accelerate their enrollment efforts and engage with the Health Benefit Exchange (HBE) to advocate on the part of patients who are having trouble getting enrolled.
Overview
WSHA has been in regular communication with our members and with the staff at the HBE about the progress and barriers of the second open enrollment period.
We have learned that despite 40,000 new enrollees this year, enrollment and renewal for qualified health plans (commercial plans) is slower than hoped. HBE staff are hoping that with the upcoming deadline, and with increased media attention around the tax penalties for being uninsured, the last several weeks will be marked by a significant amount of traffic. In light of that, the Exchange is doing enrollment events in public places across the state, and extending call center hours into the evening and weekends through February 15.
We have also shared with HBE staff some of the feedback we’ve received from our members— information and advice that might be relevant to your experiences:
- If you are working with an enrollee who has submitted documents that have not been reviewed or approved, call the call center.
- The call center is now taking appointments for staff who are working on enrollment. During these appointments, call center staff can help you with questions about multiple enrollees.
- Remember that local lead organizations have enhanced access to enrollee files and can directly resolve many enrollment issues.
- Originally, a distinction was made between In-Person Assisters (IPAs) and Certified Application Counselors (CACs): CACs had a great deal more access to enrollee data, and thus were able to work with enrollees to resolve their more complex enrollment problems. Hospitals had to choose whether to train staff as IPAs or CACs. The Exchange has revised this; there is no difference between the two categories and CACs have the same access as IPAs.
- Some of our members tell us they are having trouble uploading documents. The Exchange advises switching internet browsers. Apparently, Google Chrome is a better browser for uploading documents.
- If you are dealing with a Medicaid enrollee and running into processing problems, please remember that your hospital can sign up to do Hospital Presumptive Eligibility and by-pass the enrollment process.
Next Steps
Please continue to keep us informed of how your enrollment activities are progressing, and if you are encountering major barriers that we could help you address with the Exchange.
We also expect there will be some media interest in enrollment activities, especially in these last two weeks. If you would like to share with us your activities, we can help you with media outreach. We can also feature your stories in the WSHA Weekly Report.
Background and References
WSHA has issued several relevant Bulletins, including:
- December 11, 2014 – HCA to Implement Hospital Presumptive Eligibility in January
- October 1, 2014 – Hospital Sponsorship of Exchange Premiums
- September 26, 2014 Certified Application Counselor Training
