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The Opportunity

The Opportunity. To maximize enrollment and retention of King County residents who will be newly eligible for healthcare coverage on January 1, 2014 80,000 newly eligible for Medicaid 100,000 eligible for affordable insurance options through the Exchange

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The Opportunity

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  1. The Opportunity • To maximize enrollment and retention of King County residents who will be newly eligible for healthcare coverage on January 1, 2014 • 80,000newly eligible for Medicaid • 100,000eligible for affordable insurance options through the Exchange • To assure businesses are aware of new coverage options and requirements

  2. King County Outreach & Enrollment Plan For the uninsured: • Education and encourage enrollment through multiple communications and outreach strategies • Targeted enrollment assistance to newly eligible at convenient sites For employers: • Education and outreach to businesses

  3. The Challenges • Confusion about what health reform is and how it affects the community • Uninsured individuals will not necessarily take the initiative to get coverage on their own • Education alone is not enough—some individuals, especially the most vulnerable, will need extra help with the enrollment process

  4. Strategies for Reaching the Uninsured • King County Cities & Seattle Districts • Health Care Partners/Providers • Colleges/Universities/Tech Schools/High Schools • Libraries • Community Centers • Housing • Homeless • Jail • Public Health’s specialty health programs (e.g., HIV/STD clinic, needle exchange) • More to come…

  5. Example: Central Seattle Uninsured <138%: 5,453 138 – 399%: 4,934 400% +: 1,677

  6. In-Person Assister Network 23 organizations with plans to reach diverse groups across King County • Population focus Geographic area Language • All of King County with a focus on: • Central Seattle • South Seattle • North Seattle • South King County • Rural King County 34 languages • Asian/Pacific Islander • Latino/ Hispanic • Black/African American • Special populations

  7. Enrollment Events October 1 Launch Event (Carolyn Downs) October 5 Garfield High School Enrollment Event October 12 Third Place Commons Enrollment Event October 19 Crossroads Mall Enrollment Event October 26 Kent Commons Community Center Enrollment Event In addition we have over 200 additional enrollment events in King County!!! kingcounty.gov/healthservices/health/personal/coverage/calendar.aspx

  8. Public Health – Seattle & King County:Lead In-Person Assister Agency

  9. What is an In-Person Assister? • Assist individuals to make informed decisions about health care coverage based on their needs and resources • One-on-one, in-person support to individuals and families • Community outreach and education

  10. ACA Requirements for In-Person Assisters • Knowledgeable in eligibility, enrollment and program requirements • Fair and impartial • Facilitate Qualified Health Plan selection • Refer to consumer assistance or ombudsman • Protect confidentiality and privacy • Cultural, language and disability access

  11. In-Person Assister Qualifications • Complete required training • Certification examination • Background check • Verification of language certification (if applicable) • Attestations - Code of Ethics, Privacy and Security

  12. Language Access Resources • Lead Organization Language Access Plan/Strategies • Web site available in English and Spanish • Key documents, such as outreach material, translated in 8 most common languages • Assess the need for language services • Bi-lingual Assister • Provide translated material • Referral to another network partner • Arrange for a translator/interpreter

  13. Disability Access • Accessible, barrier free settings • Material in alternative formats, such as large print • Organizational policies/procedures for providing accessible services • Inform individuals about their right to receive disability-related accommodations and how to request these services

  14. In-Person Assister Functions

  15. One-on-One Consumer Assistance • Program overview • Using the Healthplanfinder and “Partnering” • Entering information in the Healthplanfinder • Explaining coverage options • Comparing, filtering using “decision support tools”

  16. Facilitate Enrollment • Medicaid • System Interface with HCA • Assignment to a Healthy Options Plan • Qualified Health Plans • Initial premium payment • Tax credits • Ongoing account access for updates or changes

  17. Information and Follow-Up • Next steps in accessing coverage • Medicaid • Notification from Health Care Authority • Designation of Plan • Check provider or preferred plan • Contact HCA to request a change • Qualified Health Plans • Designation of a primary care provider • Getting started

  18. Qualified Health Plans • Commercial plans offered through the Healthplanfinder • Health Management Organization (HMO) • Preferred Provider Organization (PPO) • Subject to open enrollment • Regulated/certified by the Office of the Insurance Commissioner • Approved by the Health Benefit Exchange

  19. What Is Washington Healthplanfinder?

  20. You Know What Is Covered

  21. Eligibility • Real-time eligibility decision • Federal-state interfaces for verification • Internal Revenue Service • Immigration and Naturalization Service • Employment Security • Automated verification • Conditional Eligibility (90 days)

  22. How Does It Work?

  23. Enrollment Begins October 1

  24. Public Health WebsiteKingcounty.gov/coverage

  25. Tool Kit

  26. Callista KennedyOutreach SpecialistPublic Health-Seattle & King County(206) 263-8368callista.kennedy@kingcounty.govQUESTIONS?

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