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1. Thanks for joining us! The webinar will start at 2:33pm While you wait, submit your name, organization, and city in the comments box www.uhcanohio.org www.ohioconsumersforhealth.org

2. Technical Details

3. General Housekeeping • Submit questions in the comment box at any point during the webinar • Opportunity to ask questions live at the end of webinar. Must have audio (telephone or mic) enabled • Copy of this powerpoint will be sent out following the webinar and is available at www.ohioconsumersforhealth.org now • Webinar is being recorded • This is a closed call

4. Presenters Nita Carter Health Equity Director, UHCAN Ohio Kathleen Gmeiner Project Director , Ohio Consumers for Health Coverage

5. What is UHCAN Ohio? Statewide, non-partisan, non-profit organization working to achieve quality, affordable health care for all Ohioans. What is the purpose of our Health Equity project? www.uhcanohio.org

6. What Is Ohio Consumers for Health Coverage? Ohio Consumers for Health Coverage is a broad based coalition working to achieve quality, affordable health care for all Ohioans. www.ohioconsumersforhealth.org

7. Overview • Basics of the ACA • Medicaid Expansion • Health Insurance Marketplace • Navigators • Mandate • What You Can Do to Help Your Members/Clients Now

8. The Affordable Care Act Expands Access to Coverage Medicaid Expansion • All adults up to 138% of the Federal Poverty Level ($15,856 per year for household of one) are eligible if Ohio accepts the expansion of Medicaid Private insurance through the Marketplace (Exchange) • Offers choices of private insurance plans (Qualified Health Plans – QHPs) with financial help available to those who qualify.

9. Why Medicaid Expansion Is So Important

10. Health Insurance Marketplace in 2014 Creates one-stop shop for easy comparison of coverage options Interesting Fact about the Marketplace: Gives consumers more choice and control Congress will get its coverage through the same Marketplaces. Subsidies for individuals and tax credits for small businesses are available to make it more affordable Offers coverage options through a website and helpline

11. What A Household of One Can Expect to Pay with a Tax Subsidy

12. Navigators – How to Get Help with the Marketplace The Marketplace is required to create a navigator program to: • Inform people about their new insurance options • Help people enroll in their plan of choice • Help people keep their coverage (stay enrolled) Insurance brokers and agents can also help. The Navigator does not choose a plan or advise which plan to choose. Navigators may not be compensated by insurers to enroll people in the Marketplace, and Ohio’s HB 3 is disqualifying providers reimbursed by insurers for medical services provided.

13. Poll: My biggest concern about Open Enrollment is: • The web site will not become fast enough to support all enrollment that is desired • I will not know where the face to face assistance is to tell my clients/constituents/members about • There will not be adequate materials in multiple languages • The people we talk to will have unrealistic expectations about the amount they will need to pay.

14. Navigators Serving Ohio • Ohio Association of Foodbanks(Serving most parts of Ohio) • Call 614 221-4336 • Anticipated grant amount: $1,958,961 • Helping Hands Community Outreach Center (Dayton) • Call 937-268-6066 • Anticipated grant amount: $230,920 • Neighborhood Health Association (Toledo) • Call 419- 720-7883 • Anticipated grant amount: $684,630

15. Navigator Collaborative of the Ohio Association of Food Banks • OhioAssociation of Foodbanks, All 88 Counties • Access Health Mahoning Valley (AHMV), Mahoning and Trumbull Counties • Asian Services in Action, Inc. (ASIA), Cuyahoga, Franklin, Hamilton, Lucas, Montgomery, and Summit Counties • Carmella Rose Health Foundation (CRHF), Cuyahoga County • Cuyahoga Health Access Partnership (CHAP), Cuyahoga County • Community Action Committee of Pike County (CACPC), Jackson, Pike, and Scioto Counties

16. Navigator Collaborative of the Ohio Association of Food Banks • Disability Rights Ohio (DRO), All 88 Counties • FreestoreFoodbank, SouthwestOhio • Toledo/Lucas County CareNetAllen, Ashland, Auglaize, Crawford, Defiance, Erie, Fulton, Hancock, Hardin, Henry, Huron, Lucas, Mercer, Ottawa, Paulding, Putnam, Richland, Sandusky, Seneca, VanWert, Williams, Woods, and Wyandot Counties • Ohio Association of Free Clinics (OAFC), 40 Counties Across Ohio • Ohio Department of Health (ODH), All 88 Counties • The Community Action Program Corporation of Washington Morgan Counties (WMCAP), Morgan and Washington Counties

17. How to Help Your Members/Clients • Become a Certified Application Counselor Organization • Get the word out about Enrollment • Encourage them to visit healthcare.gov and sign up for email updates • Include articles in your newsletter • Print materials/handouts • Invite Enroll America to your meetings • Schedule a presentation with UHCAN Ohio

18. Become a Certified Application Counselor (CAC) • CACs are trained by the federal government to help people understand their choices under the Affordable Care Act. The training is free. • CACs are usually people working in agencies or organizations that help people secure health care or other benefits. • CACs are not paid by the federal government to do their work, but some private money may be available.

19. How to Become A CAC 1. Find out what is required of a CAC. http://marketplace.cms.gov/help-us/cac.html 2.Fill out an application on-line found at   http://marketplace.cms.gov/help-us/cac-apply.html (Application takes about 15 minutes to fill out) 3. Someone from Center on Consumer Information and Insurance Oversight (CCIIO) will contact those organizations who appear to have the qualifications to get more detail.

20. How to Become a CAC (continued) An organization that wants to be a CAC should: 1. Already be helping people to secure assistance of some kind. 2. Have a system for protecting confidential client data 3. Screen employees and volunteers who help clients and handle sensitive information

21. Becoming a CAC (continued) 4. Be aware of any relationships with insurance companies or others that could pose a conflict of interest and be prepared to discuss with CCIIO. 5. Be prepared to enter into a written agreement with CCIIO. 6. Identify who in your organization will be trained to be a CAC.

22. What are the benefits to becoming a designated CAC organization? A: CAC designated organizations will benefit by receiving the Marketplace’s training and being able to represent themselves to consumers as being certified by their state’s Marketplace to provide application and enrollment assistance. In addition, becoming a CAC will build the capacity of the organization’s staff and volunteers which will build their own marketability.

23. Training To Be a CAC How will training work? A: Because the CAC training is web-based, it can be completed at any time. Individual CACs must complete the training before being certified by their designated CAC organization. How many hours will the CAC training be? A: Approximately 5 hours. Do all of our employees/volunteers need to take the training or just those it wants to certify to be CACs? A: Only those who will be certified to be CACs are required to take and pass the CAC training.

24. Screening to Be a CAC What does it mean to screen staff and volunteers who would become individual CACs? A: Screening could involve background checks, calling past employers for references, checking government-issued identification, or other tools that will tell whether the organization can trust its staff and volunteers to handle any private consumer information responsibly and securely, to adhere to all CAC program requirements and standards, and to act in the best interest of the consumers they assist.

25. Screening to be a CAC What level of health care knowledge should an individual already have to become a CAC? A: There is no minimum level of knowledge required for an individual to be certified as a CAC, other than completing the required CAC training. The training will teach each individual CAC everything he or she needs to know to help consumers apply for and enroll in coverage.

26. Role of CAC Can a CAC actually help an individual compare health plans and assist the individual in choosing a health plan? A: Yes, those are required duties of a CAC. But remember that a CAC cannot actually choose a plan or enroll someone in a plan. A CAC may only assist with plan selection and enrollment, and must provide this assistance in the consumer’s best interest.

27. Role of CAC Are there quotas for how many consumers each CAC or designated CAC organization must assist? A: No. There are no requirements regarding the minimum number of consumers a designated CAC organization or each CAC must assist. About how long on average will it take a CAC to walk a consumer through enrollment? A: It will vary depending on the consumer’s needs. We estimate that it will take about one hour to walk a typical client through the entire process.

28. Difference Between and CAC and a Navigator? Navigators: • Funded through grants through the Marketplace • Strict conflict of interest requirements • Required to conduct outreach and education CACs: • Not funded through Marketplace but may obtain finding from other sources • Conflict of interest disclosure requirements but won't prevent from becoming a CAC • Not required to conduct outreach and education

29. Difference Between CAC and Broker? A: Unlike agents and brokers, CACs cannot charge consumers for their assistance and are not paid by health insurers to sell insurance. Agents and brokers are licensed by their state to sell insurance. CACs do not sell insurance, nor will they be enrolling individuals in health coverage, including QHPs offered through the Marketplace.

30. How to Become a CAC (continued) Think through how you plan to help people. • Will you establish an appointment system? • Will you set up certain days of the week that you have “first come, first serve” clinics? • Will you partner with others who are knowledgeable (eg brokers, tax preparers) Conflict of interest rules apply

31. Poll: After learning more about becoming a CAC, • I think my organization might want to become a CAC • I need more information about the responsibilities of a CAC • I think it would be too hard for my organization to be a CAC

32. Get The Word Out About Enrollment Put an article in your newsletter • In your next newsletter you can drop in this article from the www.healthcare.gov web site. • Excerpt: No doubt you’ve been starting to hear about the new Health Insurance Marketplace, a key part of the health care law that will be open for business on October 1st. But you probably still have questions … • Find the full version at: http://marketplace.cms.gov/getofficialresources/publications-and-articles/relaunch-drop-in-article.pdf

33. Download and Customize Materials from Healthcare.gov • Go to marketplace.cms.gov • Click on “Get Official Resources” • Click on “Publications and Articles”

34. About the Health Insurance Marketplace – Pg 1 Click here for this publication

35. About the Health Insurance Marketplace – Pg 2 Click here for this publication

36. The Value of Health Insurance – Pg 1 Click here for this publication

37. The Value of Insurance – Pg 2 Click here for this publication

38. Things to Think About When Choosing a Health Plan Click here for this publication

39. Key Questions and Answers Q: If I am eligible for a subsidy, how will I receive it? A. You have several choices. (1) You can ask for your subsidy as an advance tax credit. Your subsidy will be paid each month by the IRS to your insurance company. (2) You can pay the whole premium and collect the tax credit at the end of the year as part of your tax refund. Ex: John’s premium is 400 per month, and based on his income he is responsible for $100 per month. The federal government will pay $300/month to the insurance company, and John must pay $100.

40. Key Questions and Answers Q : I have been turned down from insurance in the past because of a pre-existing medical condition. Can the insurance companies still do that? A: No, insurance companies cannot do that. They can charge different premiums based only on these factors: • Size of household • Age • Geography • Tobacco Use

41. Key Questions and Answers Q: If I am working, but can’t afford the cost of buying my employer’s insurance, can I go to the Marketplace where I might be eligible for a subsidy? A: You can only get buy insurance in the Marketplace with a subsidy if certain conditions are met. If you cannot afford your employer’s insurance, seek help from a broker or navigator to determine if you might meet those conditions.

42. Key Question and Answers Q: My spouse gets coverage from her job, but it doesn’t cover me. Can I go to the Marketplace and get a subsidy? A: It depends. The spouse can go the Marketplace and get a subsidy • If the employer does not offer* coverage for the spouse, OR • If the cost of the employee’s share of premium is greater than 9.5% of the HOUSEHOLD income. • The insurance does not meet minimum value as required by the ACA. *The employer may offer coverage for the spouse, without financially contributing to the cost of the insurance.

43. What Individuals Should Do Now • Sign up for emails to get the most up to date information about enrollment at www.healthcare.gov • If you get your health insurance at work, find out if your employer offers coverage for your spouse, even if employer does not contribute to it. • Find out your estimated expected contribution to your monthly premium at www.kff.org and click calculator.

44. What Individuals Should Do Now • Estimate what your income will be in 2014. • Create a budget that includes your share of premium. If your likely share of premium doesn’t fit into your budget, you should still seek help from a navigator or a broker after Open Enrollment starts October 1.

45. For More Information Healthcare.gov Helpline By phone -- available 24/7 • 1-800-318-2596 • TTY: 1-855-889-4325 On-line www.healthcare.gov

46. Get Involved! • Reach out to UHCAN Ohio to help you as you pursue your work as a Certified Application Counselor. • Invite UHCAN Ohio to send a speaker to your organization/faith congregation . • Volunteer with Enroll America to canvass neighborhoods and table • Stay informed by following us on Facebook and Twitter • Join our newsletter by signing up on our website

47. Questions? Submit questions using the GoToWebinar comment box or "raise your hand" to ask your question live (Audio settings must be enabled either through your telephone or the mic in your computer to ask a question live) You can also submit a question at www.uhcanohio.org.

48. For More Information Visit These Websites: Need Help? Call our helpline at 614-456-0060 x233 www.uhcanohio.org www.ohioconsumersforhealth.org www.healthcare.gov www.aarp.org www.kff.org

49. Poll: Would you like to join our email list? • Yes • No

50. Thanks for Participating! Nita Carter UHCAN Ohio ncarter@uhcanohio.org 614-456-0060 x224 www.uhcanohio.org Kathleen Gmeiner Ohio Consumers for Health Coverage kgmeiner@uhcanohio.org 614-456-0060 x223 www.ohioconsumersforhealth.org UHCAN Ohio Ohio Consumers for Health @UHCANOhio @KathleenOCHC A copy of this powerpoint will be sent to you in a follow—up email