ACA Overview: Connecting Indiana Library Patrons to Affordable Care Act Resources
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ACA Overview: Connecting Indiana Library Patrons to Affordable Care Act Resources
- 1. ACA Overview: Connecting Your Library Patrons to Affordable Care Act Resources Indiana State Library Professional Development Office
- 2. Libraries and Health 2 A survey was conducted in 2012 and showed that 47% of patrons retrieve health information online at libraries An increase of 10% from 2011 People realize that libraries are excellent source of reliable health information Patrons realize that libraries are neutral places Indiana State Library 1/7/2014
- 3. Agenda 3 Patient Protection & Affordable Care Act (PPACA) Health Insurance Marketplace Overview Resources Serving our patrons & what other libraries are doing FAQs Sources for more training Indiana State Library 1/7/2014
- 4. Patient Protection & Affordable Care Act 4 The comprehensive health care reform law was enacted in two parts: Patient Protection and Affordable Care Act was signed into law on March 23, 2010 . Amended by the Health Care and Education Reconciliation Act on March 30, 2010. “Affordable Care Act” is used to refer to the final, amended version of the law Indiana State Library 1/7/2014
- 5. Health Insurance Marketplace 5 The Marketplace is a new way to find health coverage that fits your budget and meets your needs. Indiana State Library 1/7/2014
- 6. Health Insurance Marketplace 6 To provide qualified individuals and employers (business owners) to have access: Affordable coverage options Ability to purchase private health insurance Access to health insurance information Allow effective comparison of qualified health plans Indiana State Library 1/7/2014
- 7. SHOP Marketplace 7 SHOP – Small Business Health Options Program Fewer than 50 fulltime-equivalent employees Find eligibility of Small Business Health Care Tax Credit Online applications began November 1st Indiana State Library 1/7/2014
- 8. Qualified Health Plans 8 Under the Affordable Care Act, starting in 2014, an insurance plan that is certified by the Health Insurance Marketplace: provides essential health benefits follows established limits on cost-sharing meets other requirements Indiana State Library 1/7/2014
- 9. Qualified Health Plans 9 Offered by an issuer that is certified by the state and should be in good standing Covers the essential health benefits Offers at least one plan – silver level or gold level of cost sharing The issuer agrees to charge the same premium rate whether it is through the marketplace or outside of it Indiana State Library 1/7/2014
- 10. Health Insurance Marketplace Help 10 Navigators Trained in an unbiased environment Adhere strongly to privacy and security laws Completed 30-40 hours of training Ongoing trainings for updates Took initial web-based training Required on-going training Required to be certified every year Indiana State Library 1/7/2014
- 11. Health Insurance Marketplace Help 11 Navigators need to meet reporting requirements Reports include – progress, financial, performance Should not be compensated by issuers – directly or indirectly ADA compliant Services are available also in Spanish Indiana State Library 1/7/2014
- 12. Health Insurance Marketplace Help 12 Certified Application Counselors and Assisters Trained to educate consumers and help complete applications Health care providers, social service organizations etc. Indiana State Library 1/7/2014
- 13. State of Indiana Navigators 13 Who must apply? Federally-funded federal Navigators. Federally-designated Certified Application Counselors. Others who help complete insurance affordability program applications. Indiana State Library Some are not eligible. Federal vs. State Navigators Need to be certified in Indiana. Federal Navigators are compensated by the federal government. No compensation for Indiana Navigators. 1/7/2014
- 14. Marketplace in Indiana 14 Determine the Marketplace in your state Federal Exchange Partnership exchange – federal and state State-based exchange – taking the lead with ACA *Eligibility of patrons depend on who is running the Marketplace. Indiana State Library 1/7/2014
- 15. Health Insurance Marketplace by State from commonwealthfund.org State Indiana State Library |Variations of State-Federal Partnerships| 15 Federal 1/7/2014
- 16. Marketplace 16 Website: www.healthcare.gov Help Center: 1-800-318-2596 Chat feature Indiana State Library 1/7/2014
- 17. SHOP 17 Website: www.healthcare.gov Help Center: 1-800-318-2596 for employees 1-800-706-7893 for employers Indiana State Library 1/7/2014
- 18. Forms of Enrollment: How to apply? 18 Initial Open enrollment – October 1, 2013 to March 31, 2014 Online application at healthcare.gov Highly suggested – immediate response if eligible Paper application – mailing of forms May take some time in getting answers Phone calls Call center‟s certified personnel can enroll patrons over the phone Person-to-person interaction Indiana State Library 1/7/2014
- 19. The Resources 19 Indiana State Library 1/7/2014
- 20. Finding Help 20 Find Local Help localhelp.healthcare.gov Indiana Health Care Reform www.in.gov/healthcarereform Indiana State Library 1/7/2014
- 21. Official Resources 21 marketplace.cms.gov Applications Informational Documents Widgets Indiana State Library 1/7/2014
- 22. Official Resources 22 productordering.cms.hhs.gov Centers for Medicare and Medicaid Services Product Ordering Website Indiana State Library 1/7/2014
- 23. Other Resources 23 INSPIRE – inspire.in.gov Affordable Care Act resources Health databases MedlinePlus Health Source: Consumer Edition Indiana State Library 1/7/2014
- 24. Other Resources 24 Health Insurance Statistics enrollamerica.org countyhealthrankings.org Federal Trade Commission ACA Fraud Alert Kaiser Family Foundation – nonpartisan site healthreform.kff.org The Law hhs.gov/healthcare/rights/law/index.html Indiana State Library 1/7/2014
- 25. Partnerships 25 Indiana Navigators – Department of Insurance in.gov/healthcarereform Find Local Help localhelp.healthcare.gov Health Resources Services Administration http://www.hrsa.gov/about/news/2013tables/ outreachandenrollment/in.html Rural Assistance Center http://www.raconline.org Indiana State Library 1/7/2014
- 26. Partnerships 26 FSSA – Indiana Family & Social Services Administration in.gov/fssa Department of Insurance in.gov/idoi Chambers of Commerce SHOP-related info sessions IN Chamber of Commerce Health Care Helpline Indiana State Library 1/7/2014
- 27. ACA & Libraries 27 Indiana State Library 1/7/2014
- 28. Serving Our Patrons: Policy 28 1. Identify the type of exchange in your state and concentrate on the information - healthcare.gov 2. Assess your staff – how can we meet the patrons‟ needs? - Computer literacy 3. Define the role of your library - information dissemination Indiana State Library 1/7/2014
- 29. Serving Our Patrons continued 29 4. Familiarize yourself with the available resources – nationally & locally 5. Review your library policies – cell phone, computer, printer use Indiana State Library 1/7/2014
- 30. Serving Our Patrons 30 Nobody is expected to be an expert Remain neutral Provide relevant, current information Connect patrons to local health organizations, centers, agencies, etc. Make appropriate referrals Indiana State Library 1/7/2014
- 31. What are other libraries doing? 31 ACA Resource Guides Indianapolis Public Library Lake County Public Library Monroe County Public Library Partnerships & Programming Waukegan Public Library, Illinois Orange County Public Library, Florida Topeka and Shawnee County Public Library Indiana State Library 1/7/2014
- 32. FAQs 32 Patron: What is the Health Insurance Marketplace? Library staff: The Marketplace is a new way to find health coverage. I can show you where to go to see all your options and enroll. In Indiana, we will use Healthcare.gov to apply. Some other states will use their own state-wide marketplace. Indiana State Library 1/7/2014
- 33. FAQs 33 Patron: What if I already have job-based insurance? Do I need to do this? Library staff: If you already have insurance, you are considered covered but, if you want to change, you may be able to explore Marketplace coverage. With most job-based health insurance plans, the employer pays a portion of the premium. If a patron chooses a Marketplace plan instead, the employer does not need to make a contribution to the premium. Indiana State Library 1/7/2014
- 34. FAQs Patron: What if I‟m a part-time employee without health coverage? Library staff: I can‟t tell you whether you are going to be covered but I can help you locate the application to find out your Healthcare Marketplace options. Consider looking at this application checklist and returning to fill out the online application with the documents listed.
- 35. FAQs 35 Patron: How do I get ready to enroll? Library staff: These flyers will help you prepare and gather all of the information you will need in order to fill out an application in the Healthcare Marketplace. You will need to bring the following information with you to enroll: SSN Birth dates Income information (from Pay stubs or W2s) Policy numbers for any current health insurance Information about any health insurance you or your family could get from your jobs. Indiana State Library 1/7/2014
- 36. FAQs 36 Patron: I‟ve heard about Healthcare Marketplace scams. How do I know if something is trustworthy? Library staff: No one should ask for personal health information. If you have any questions, don‟t give out information. Keep personal and account numbers private. Don‟t release this information to companies you didn‟t contact or in response to unsolicited advertisements. Don‟t give your personal health or financial information to someone who calls or comes to your home uninvited, even if they say they are from the Marketplace. Indiana State Library 1/7/2014
- 37. Additional Trainings 37 Indiana State Library 1/7/2014
- 38. Trainings: Webinars 38 marketplace.cms.gov Patient Protection and Affordable Care Act webinar by ISL legal interns WebJunction Indiana‟s Health Happens in Libraries page INSPIRE Indiana State Library 1/7/2014
- 39. Training: Email Updates 39 CMS – marketplace.cms.gov Healthcare.gov Webjunction Indiana Health Happens in Libraries Under „Get Involved‟ National Network of Libraries of Medicine nnlm.gov Social Media Indiana Library Listservs Indiana State Library 1/7/2014
- 40. Questions? 40 by Horia Varlan, Flickr Creative Commons Indiana State Library 1/7/2014
- 41. Contact 41 Sara O‟Sha Northeast Regional Coordinator Indiana State Library Professional Development Office (317) 447-0452 sosha@library.in.gov Indiana State Library 1/7/2014
Notas do Editor
- PPACA - Patient Protection and Affordable Care ActAccording to the Pew Research Center…We are also already used to assisting with e-government services as Government agencies at the local, state, and federal level are increasingly moving online to provide services directly to the public
- Patient Protection & Affordable Care Act (PPACA)Health Insurance MarketplaceQualified Health PlansNavigatorsTypes of applicationSome of the key datesResourcesWebsite links & other info sourcesCommunity PartnersServing our patrons & what other libraries are doingFAQSources for more training
- The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 andAmended by the Health Care and Education Reconciliation Act on March 30, 2010. The name “Affordable Care Act” is used to refer to the final, amended version of the law.
- Definition from Healthcare.gov
- Also will see if eligible for tax credit.According to the CMS 90% of the currently uninsured will likely qualify for free or discounted insurance through the Marketplace.To be eligible (of course not our place as library staff to determine) - US Citizen, National or otherwise lawfully present - not incarcerated - live in service area (State based system, we’ll talk about this more)Can enroll in Medicaid through the MarketplaceMedicare (seniors) – do not need to do anything
- SHOP is the employer side of the Healthcare exchanges.Fewer than 50 employees – this will go up in 2016 to 100Small Business Health Care Tax Credit - Beginning in 2014 the tax credit is available only for plans purchased through SHOP. fewer than 25 “full time equivalent” employees average wage < 50k per year contribute at least 50% of premium costEmployers must apply prior to employees online application November 1st enroll – aka “offer coverage” to all FT employees (work 30 hours or more) notify employees – they apply and enroll online
- Under the Affordable Care Act, starting in 2014, an insurance plan that is certified by the Health Insurance Marketplace:As defined by the CMS, Qualified Health Plan (QHPs):provides essential health benefits (there are 10 essential benefits such as emergency care, maternity and infant care, preventative and wellness services etc.)follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts)meets other requirements [interested parties can find and read the entire law online]A qualified health plan will have a certification by each Marketplace in which it is sold.
- Apples-to-apples comparisonCatastrophic plans will also be available for those under 30
- Federally funded through grantsFederally funded Navigators operating in Indiana must also be certified by the State (Department of Insurance) and will be subject to Indiana regulation and monitoring practices.
- Indiana Navigators must also complete a Conflict of Interest form, go through a background check and pass Indiana Navigator Certification Exam.
- Certified Application Councilors (CAC) also will be available for help, they are:trained to educate consumers and help complete applications not Federal grant funded health care providers, social service organizations etc. Some community health center or other health care provider, hospital, a non-federal governmental or non-profit social service agencies have decided to help by training their staff to assist people applying for coverage through the Marketplace.
- Some are not eligible:Individuals receiving compensation for the sale of health insurance.Individuals receiving compensation from health insurance issuers.No compensation for IN navigators:“Does it cost anything to use an Indiana Navigator? Perhaps. Consumers may be charged for using an Indiana Navigator. If an Indiana Navigator is also a Federal Navigator, he is she is forbidden from receiving compensation for his or her services because he or she is already receiving compensation from the Department of Health and Human Services. It is at the discretion of Indiana Navigators or their Application Organizations whether to charge for their assistance. Consumers should be aware of whether an Indiana Navigator requires compensation before using the Navigator’s services.”
- When you have Medicare/Medicaid and CHIP (Children’s Health Insurance Plan), you cannot apply for a supplement in the marketplace.
- Indiana, along with 18 other states, has a federally-facilitated marketplace
- Also called the Health Care Exchange.
- Employers and employees will still go to healthcare.gov to apply and enroll in SHOPEmployees will use the same phone number for help* There is a special 800 number for small business employers and brokers/agents helping them enroll
- After this initial open enrollment period of Oct. 1, 2013 to March 31, 2014, annual open enrollment will be from Oct. 15th to Dec. 7th starting in October 2014. Must enroll by Dec. 23, 2013 for coverage to start on Jan 1, 2014. (this deadline was extended Nov., 2013)Special enrollments may occur throughout the year due to circumstanceslike moving to a different state, losing employer-supplied coverage etc.2014 (when file taxes in early 2015) some people who remain uninsured might have to pay fee - Starting January 1, 2014, if someone doesn't have a health plan that qualifies as minimum essential coverage, he or she may have to pay a fee that increases every year: from 1% of income (or $95 per adult, whichever is higher) in 2014 to 2.5% of income (or $695 per adult) in 2016. The fee for children is half the adult amount. The fee is paid on the 2014 federal income tax form, which is completed in 2015. Enroll through the marketplace by March 31st and no penalty otherwise 1/12 penalty per month uninsured- some income and other exemptions may apply (religious reasons, premium over a certain % household income etc.)
- In addition to healthcare.gov, the sites and sources you need to know. Potential community partners will also be covered.
- Where to find face to face help for library patronsFind local help: on federal website - link on front page or healthcare.gov - find CACs, SHOP help and more in your areaIndiana Health Care Reform – source for IN Navigators - organized by county w/ their “application organization” listed
- Get Official Resources through the CMS websiteApplications – some of your patrons will surely prefer paper applications, may consider printing a few off to have on hand, but at the least should know where to find them - separate applications for individuals/families/shop etc.Informational Documents – plenty of great documents like “prepare to enroll,” Key dates,” and “about the marketplace”Widgets – if you’d like to add graphical links to the marketplace to your website
- saraoshalibrary310Recently announced that print publications like applications can be ordered through productordering.cms.hhs.govAccording to the CMS webpage these materials will be free of charge, but you will need to create an account and include why you would like to order materials.
- ACA Resources includes many of the resources and links I am covering today &ACA newsTraining resourcesIndiana Navigator and Partners linksHealth Source: Consumer EditionRich collection of consumer health information available to libraries worldwide. This resource provides access to nearly 300 full text, consumer health periodicals, including American Fitness, Better Nutrition, Fit Pregnancy, Harvard Health Letter, HealthFacts, Men's Health, Muscle & Fitness, Prevention, Vegetarian Times, and many others. MedlinePlusMedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Other Health databases available on INSPIRE like Biomedical Reference Collection, Health Source, Health Business and more that provide journal articles in various medical-related disciplines
- Several tools are designed to give you an idea of how many citizens in your area are uninsured.http://www.enrollamerica.org/maps - Screenshot to the rightwww.countyhealthrankings.orgFederal Trade Commission ACA Fraud AlertGeneral information about fraud along with blog updatesCMS also has an Official Resource available on Marketplace fraudKaiser Family Foundation – nonpartisan site with tools like a subsidy calculator, health reform timeline and videos and other resources to help people understand the law.
- Your first places to look for in-person help and programming for your patrons will probably be the Indiana State Navigator page and the local help database on healthcare.gov, but there are some other options.HRSAIndiana: Health Center Outreach & Enrollment Assistance: Indiana has 19 health centers with 102 sites that served 285,940 patients last year, Thehealth centers on the list expect to hire 47 additional workers to assist 87,995 people with enrollment into health insurance coverage.Rural Assistance Center A product of the U.S. Department of Health and Human Services’ Rural Initiative, the Rural Assistance Center (RAC) was established in December 2002 as a rural health and human services "information portal." RAC helps rural communities and other rural stakeholders access the full range of available programs, funding, and research that can enable them to provide quality health and human services to rural residents.
- FSSA-Providing trainers out in the field. There may be a potential to offer these trainers space at libraries in the state to work with your library patrons. We will keep everyone posted on these ongoing opportunities.Dept. of Insurance-Managing and facilitating a statewide navigators program. We will keep everyone posted on these ongoing opportunities.
- Thinking about policy and what other libraries are doing to assist with the new healthcare law.
- Library staff will be expected to provide information, while at the same time, avoid consulting and giving advice.If you are unsure of whether an answer would cross the line into advice, encourage the patron to call or show them how to online chat with healthcare.gov.
- Computer/Printer Use:Application may take longer than your typical computer sessionDepending on the traffic you are experiencing, you may consider setting up workstations dedicated to ACA activitiesWorkstations should be connected to printer
- Local decision on how to manage ACA information.-Nobody is expected to be an expert, so know when to make a referral, and how to find help (800 #, navigators etc.)\We should however know the basics and help with basic functions on the healthcare.gov website*Remain neutral – challenges- health care has become a highly politicized topic (do not engage in political debate)- provide information and resources, not advice (selecting plans etc.), this goes for general consumer health questions as well- protect patron privacy *Provide relevant reliable information – direct patrons to proper consumer health resources like MedlinePlusIncreasing patron awareness of the library’s resources on health.Stay current on your sources so you can provide relevant, current information*Make appropriate referrals*Connect to local health centers or helping agenciesThink of tax time!
- Waukegan Public Library-County-wide partnerships with many organizations in their county.Topeka and Shawnee County Public Library-Public meetings and informational settings to introduce the marketplace and take general questions.Orange County Public Library-Website, public meetings and trainings, partnerships with local chamber of commerce for trainingsMight consider working with local groups to provide programming about budgeting for healtcare, healthcare vocabulary or other topics that might be helpful to those investigation insurance coverage or that are newly insured in your community.There are also several libraries in Indiana that are being recognized as “Champions for Coverage” by the CMS for sharing information about the Marketplace. Learn more and apply at marketplace.cms.gov
- After this initial open enrollment period of Oct. 1, 2013 to March 31, 2014, annual open enrollment will be from Oct. 15th to Dec. 7th starting in October 2014. Special enrollments may occur throughout the year due to circumstances like moving to a different state, losing employer-supplied coverage etc.“afford health insurance” – exemptions might include not only income, but other situations. Recommend they go to healthcare.gov for a complete list or contact a Navigator for help specific to their situation.Although we are not helping people with the details of the application process or assisting in selecting plans, we should be equipped with the general facts the public will want to know.
- I will help you locate the online application so you can explore your options.There are also tools to “see plans before I apply” and “see if I can get lower costs” on healthcare.gov that do not require an account or complete application to explore.
- ALSO – to complete an application patron will have to create an accountEmail address is requiredI’d encourage patrons to create account/email information they will remember so they will have an easier time logging in next yearPassword and security questions also requiredHealthcare.gov has some great FAQs that I’d encourage you to explore that will help you answer general questions. While we aren’t expected to be experts, having some general knowledge of key points, resources, and dates will allow you to better serve your patrons.
- These suggestions are based on the FTC guidelines and the “Protect yourself from Fraud in the Health Insurance Marketplace” official document found on the CMS website.
- You may want to designate a couple people on your staff to stay up to date on ACA information.
- NNLM – join the network to receive updatesSocial Media – there are official Marketplace accounts on Facebook, Twitter and YouTube
- As a WebJunction partner, ISL will be regularly gathering questions and comments from Indiana libraries regarding ACA and funneling them to IMLS through WebJunction.Please feel free to email the Indiana State Library with any questions, comments or requests.We will be sharing any additional big news/helpful resources on the inlibraries and inpubliblistservs as they develop and become available!