Things are developing at a rapid pace for outreach and enrollment entities and workers, including Certified Application Assistants, Certified Enrollment Entities, Certified Enrollment Counselors, Promotores, and future Navigators. CCHI’s “Assister’s Corner” is designed to keep you up to date on the issues that matter most to assisters as well as find the latest information to support your role in enrolling children and families into affordable coverage.
Latest Assister News
Covered California Program Update (posted 5/27/14) At the most recent Covered California staff presented their recommendations for revamping the Certified Enrollment Entity, Outreach & Education Grant, and Navigator Programs. The main points of their proposal are:
Covered California staff recommended integrating the Outreach & Education Grant Program with the Certified Enrollment Entity Program to create a more robust Navigator program.
CC staff recommends retaining the current O&E Grants and CEEs through the end of the 2014-15 open enrollment period then converting solely to a Navigator Program.
CC staff recommends O&E and CEEs to apply for Navigator grants to convert as soon as possible. They hope to open up a new Navigator Grant RFA in June, to be completed by the end of July.
Covered California Board will take a vote on the recommendation at the June 19th Board Meeting.
Important Information Regarding the Certified Application Assister Program (posted 4/29/14): CCHI was closely involved in the development of a Certified Application Assister Program Bulletin (click for link to bulletin) jointly from DHCS and Covered California which explains things moving forward after the completed Healthy Families Transition.
Kaiser Child Health Program Update (posted 4/4/14): In the course of moving KPCHP members to the new Child Health Program, termination letters were sent to a significant number of our members in error. The letters were mailed beginning 3/28/2014 and indicate coverage will terminate 5/1/2014; this is incorrect. All of our members who have a monthly payment, will remain in the Program as long as they continue to make their monthly payment.Renewal information about the KP CA Platinum 0/20 plan will be sent to members in the Fall and Child Health Program recertification information will be sent to our members in early 2015.As a result of this error, KPCHP phone lines are jammed and callers are experiencing at least a 30 minute wait. KPCHP apologizes for the error and ensuing confusion. We will issue a correction and apology letter to members (in their preferred language) as soon as possible.
CCHI and Community Health Councils have developed an Enrollment Feedback Survey to collect the barriers or issues assisters may be facing during the enrollment and eligibility process. We ask that you complete this survey as often as you like whenever you encounter a barrier. We will use this information to make recommendations to Covered California and the Medi-Cal program. This survey is not designed to troubleshoot issues, but to simply document barriers encountered.
CalFresh Express Lane Enrollment Update (posted 02/20/14): CCHI in collaboration with DHCS hosted a ELE Informational Webinar on how CAAs and CECs can help families take advantage of this opportunity to enroll up to 550,000 adults and 153,000 children currently in CalFresh into Medi-Cal.
CalFresh Express Lane Enrollment (posted 02/10/2014): Great news for CalFresh enrollees! California has decided to use CalFresh to “express enroll” 153,000 children and approximately 550,000 adults who are enrolled in CalFresh but not Medi-Cal. The “Express Lane Enrollment” process will allow these individuals to be immediately enrolled into Medi-Cal by simply giving their permission. No application needed!In order to enroll, all families will need is their unique PIN and they can enroll by signing and returning the letter, calling 1 (844) 212-0003, or go online to http://dhcs.ca.gov/ExpressLane.For all of these enrollments, the family will need to give their PIN listed on top of the letter they receive. For more information, please check out this Express Lane Enrollment FAQ (English). (Click here for the Spanish version of the FAQ)
CEE/CEC Help Line (posted 02/05/14): GOOD NEWS! Covered California has established a dedicated CEE/CEC Help Line. If you haven’t already received a notice from Covered CA and would like the CEE/CEC help line number, please contact CCHI.The CEE/CEC Help Line hours are Monday through Friday, 8am to 5pm for direct assistance with the following:
Status update on paper applications submitted
General CalHEERS errors
CEE, CEC & CAA Support Materials
U.S. Immigration and Customs Enforcement (ICE) – Clarification of Existing Practices Related to Certain Health Care Information: The Patient Protection and Affordable Care Act (ACA), Pub. L. No. 111-148, 124 Stat. 224, and the Social Security Act (SSA) require that individuals seeking coverage under a qualified health plan offered on a Health Insurance Marketplace or through an insurance affordability program (i.e., premium tax credits, cost sharing reductions, Medicaid, Children’s Health Insurance Program, or Basic Health Program) provide information regarding their immigration status and certain information about their household members to determine eligibility for such coverage. This memorandum sets forth U.S. Immigration and Customs Enforcement (ICE) civil immigration enforcement policy regarding information concerning such individuals and their household members obtained during the eligibility determination process for such coverage. Click HERE for full language ICE Notice.This guidance document is also available in Spanish.
HealthTaxCreditTool.org is an easy to use tool to help families better understand the health premium tax credits, a new way to lower the cost of health insurance under the Affordable Care Act. This tool is made possible through a collaboration of the Robert Wood Johnson Foundation and Consumers Union/Consumers Report.
Beginning January 1, 2014, California is expanding health care coverage options for immigrants! CCHI has created a straightforward fact sheet to help guide you through those changes and learn what benefits immigrant families and children are eligible for. You can find that fact sheet HERE
For Covered California’s Immigrant Coverage FAQs you can click HERE for the English and HEREfor the Spanish version
For and in-depth look at the DACA recipients and the full range of benefits they qualify for, please follow the links to these documents from the California Immigrant Policy Center:
Who will help families to complete applications for coverage through Covered California and Medi-Cal?
Once an entity becomes certified what are CEE’s responsibilities under Covered California?
Is there compensation for enrollments?
Will there be further trainings and supplemental supports for CECs?
Check out our Best Practice training and support materials from our webinar with Covered California and Department of Health Care Services on how organization and individuals can become CEEs/CECs and help provide application assistance to eligible consumers under Covered California as well as Medi-Cal.
Previous Assister News
Transitioned HFP Children Discontinuances (posted 02/04/14): The Department of Health Care Services recently disenrolled Healthy Families Program children who failed to return their AER in the month of November 2013. Due to the sensitive nature of the large number of November 2013 discontinuances, DHCS determined that the affected beneficiaries will be reinstated in Medi-Cal and will be provided with an additional opportunity to return their AER. During early January 2014, families that have not already sent in AERs received a letter advising that eligibility for fee-for service Medi-Cal coverage has been reinstated going back to December 1st.DHCS is asking that CAAs assist by:
Helping them complete the duplicate AER form and submit the needed paperwork by the due date.
Inform the family of the importance of returning the AER prior to the date of discontinuance in order to remain on their health plan during the eligibility determination.
Help families request duplicate AER forms by calling Medi-Cal for Families at 1-800- 880-5305 to request a duplicate AER form if the family misplaces it.Note: If the family does not submit the form by the due date, encourage the family to still submit the completed AER form within the 30 days after the discontinuance date on the notice of action.
AIM-Linked Infants (posted 02/04/14): During Healthy Families Program transition to Medi-Cal, AIM-linked infants and children were moved to the Medi-Cal health plans during the transition phases in August and November. As of February 1, 2014, all currently registered AIM Linked infants will be served by DHCS health care delivery systems receiving care through Medi-Cal providers and managed health care plans. Notification letters were mailed to all currently enrolled AIM subscribers to inform them that when their infant is born, they should send in the Infant Registration Form to the AIM Program
How Can CAAs Help Families? CAAs can help by encouraging the moms to submit all the needed paperwork on time to the AIM Program and to fill out any paperwork to enroll their baby in Medi-Cal managed care health plans. If you have questions, please contact the HFPTransition email box at HFPTransition@dhcs.ca.gov.
Information About Pending Medi-Cal Applications (Posted 01/08/14): Due to the large number of Medi-Cal applications received through the Covered California website, the Department of Health Care Services (DHCS) will provide temporary Medi-Cal eligibility for many individuals and families while their applications are being verified. This temporary coverage, called presumptive eligibility, will allow individuals/families to receive Medi-Cal coverage starting January 1, 2014 while their application is being verified. As part of the verification process, county human services offices will review state residency, citizenship, immigration status and income.If the individual or family’s Covered California application was still pending approval for Medi-Cal on or before December 14, they will likely get this temporary Medi-Cal coverage. If so, DHCS will send a letter to inform them of their status. The letter will also remind them to quickly send any information requested by their county human services office to finish verifying their eligibility. Their Medi-Cal Benefits Identification Card (BIC) will be mailed to them shortly, and coverage will have begun January 1, 2014.Some applications with incomplete or incorrect information may not be able to get temporary Medi-Cal coverage. The individual’s or family’s county human services office will be able to tell them if they have temporary coverage. Even if they do not get the temporary coverage, once their eligibility is confirmed their coverage will become effective as of January 1, 2014. If an individual or family needs medical care in early January, and does not have temporary coverage under presumptive eligibility, they may be able to get medical care through Medi-Cal coverage in the following ways:
Some hospitals can provide temporary Medi-Cal coverage for adults, pregnant women, children, and former foster youth.
Pregnant women can get temporary Medi-Cal coverage from certain Medi-Cal providers and clinics.
Children can get temporary Medi-Cal coverage from certain Medi-Cal providers and clinics who see children.
Health-e-App ANNOUNCEMENT: As of December 31st, 2013, Health-e-App will no longer process joint Medi-Cal/Healthy Families Program applications. MAXIMUS will forward all paper applications received after December 31st directly to the counties, who will continue to accept joint paper applications through 2016. Please feel free to contact Autumn Ogden at CCHI with any questions at email@example.com.
DHCS ANNOUNCEMENT: Medi-Cal Beneficiaries that are up for renewal in the months of January, February, and March of 2014 will not be receiving their renewal package as normal. Instead, those that would have been scheduled to come up for renewal in January will renew in the month of April 2014, February renewals will be moved to May 2014, and March renewals will be moved to June 2014. Beneficiaries will not be dropped from Medi-Cal and will retain coverage during this renewal period delay. See this All County Welfare Directors’ Letter (CLICK HERE) for details and reference. If you are an assister and receive inquiries from families on this issue please contact CCHI.
CCHI is a leader in health advocacy for children and families and is recognized as a statewide network of community organizations that champion enrollment in health coverage, access to care and other services.