REMINDER: 2015 Open Enrollment Period Begins November 15, 2014

The open enrollment period for the 2015 plan year will begin on November 15, 2014 and continue through February 15, 2015.
As a reminder, while open enrollment offers the opportunity for all qualified individuals to apply for coverage, consumers may be able to enroll in health coverage outside of open enrollment if: 1) they qualify for a special enrollment period (SEP); 2) they are enrolling through the Small Business Health Options Program (SHOP); or 3) they are eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

• For more information on open enrollment, check out the fact sheet found here: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-03-05-2.html
• For more information on SEPs, see this page on HealthCare.gov: https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-enrollment/

Updated Healthcare.gov Content Lists 2015 Maximum Out of Pocket Costs

Earlier this month, Healthcare.gov was updated with new content that lists the 2015 maximum out of pocket costs for all Marketplace plans.

The maximum out-of-pocket costs for any Marketplace plan for 2015 are $6,600 for an individual plan and $13,200 for a family plan. When the total amount a consumer pays in deductibles, copayments, and coinsurance reaches these limits, the insurance company pays 100% of the consumer’s costs for covered care. These limits apply even for consumers who choose a catastrophic coverage plan. Monthly premiums do not count towards the out-of-pocket maximum.
• To view the new “Out-of-pocket costs” page, use this link: https://www.healthcare.gov/choose-a-plan/out-of-pocket-costs/

UNMC will hold Nursing Showcase this weekend at Center for Nursing Science on Nov. 2 from 2-4pm

The University of Nebraska Medical Center will hold its Nursing Showcase on Sunday at its Center for Nursing Science, 4101 Dewey Ave.

The showcase, for those interested in becoming nurses, will be from 2 p.m. to 4 p.m. Attendees will learn about the profession, financial aid, how to be a competitive applicant and what it is like to be a nursing student. They also will have the chance to use a simulation lab.

Parking is available in the parking garage north of the Center for Nursing Science. Surface parking is available north and east of the nursing center. To reserve a seat or for more information, call the college at 402-559-4110 or contact it by email at unmcnursing@unmc.edu.

Integrating 340B Drug Pricing Program Assessment with Health Center Program Site Visits

In an effort to coordinate across HRSA programs, effectively utilize HRSA resources, and reduce burden on health centers, all Operational Site Visits (OSVs) conducted on or after October 1, 2014 for health centers that also participate in the 340B Drug Pricing Program, will now include a brief assessment of compliance with 340B program requirements.

OSV consultants will assess 340B compliance using a set of standard questions. The responses to these questions will be shared directly with HRSA’s Office of Pharmacy Affairs for review and follow up as needed. Health centers can direct any questions about 340B compliance to ApexusAnswers@340bpvp.com.

NEW DEEP DIVE/PARTNER & CMS RESOURCES: Tips on Working with the Press

Many of the CMS external partners have developed tools, tips, materials, or training sessions that assisters can use. CMS shares those resources through this weekly newsletter and by posting on Marketplace.cms.gov. If you would like to recommend helpful resources, please email CACQuestions@cms.hhs.gov. CMS will be limited to sharing resources that are (1) applicable to assisters facilitating enrollment in the Federally-facilitated Marketplaces (including State Partnership Marketplaces); (2) open and accessible to the public; and (3) reviewed by CMS.

The October 10, 2014 assister webinar included a presentation by Families USA that offered 10 tips to use when working with the media. The webinar covered responding to questions from reporters and interview preparation strategies intended to help you engage local and state media and get your message to the community.

• To view the slide presentation from the October 10, 2014 CMS assister webinar, use this link: http://familiesusa.org/sites/default/files/documents/CCIIO-Powerpoint-102014.pdf
• To view a list of the 10 tips covered in this webinar, use this link: http://familiesusa.org/sites/default/files/product_documents/Media%20Interview%20Tip%20Card.pdf
• To listen to a more in-depth interview on speaking with the press and the importance of messaging featuring Becky Watt Knight of GYMR and Jodi Ray of Florida Covering Kids and Families, use this link: https://cc.readytalk.com/cc/playback/Playback.do?id=3t36d1

Additional Families USA Resources:

• Families USA’s Enrollment Assister Resource Center offers information, tools, and resources to help you run your program effectively. Families USA resources include health literacy FAQs, outreach tips and tactics, consumer brochures, analyses of federal regulations, and enrollment best practices. Use this link to access the Families USA Enrollment Assister Resource Center: http://familiesusa.org/initiatives/enrollment-assister-resource-center. Families USA frequently update their resource center with new resources and updates, so bookmark it today.
• To view the Families USA tool for story sharing, use this link: www.mycoveragestory.org which makes it easy for consumers to share their enrollment stories and get the word out to people across the country about getting covered. Collecting consumer stories raises awareness about the financial help available and allows consumers to share their experiences. If you would like advice from Families USA on collecting consumers’ stories, contact assisters@familiesusa.org.

NOTE: Marketplace.cms.gov includes links to other federal agencies and in some instances, non-government Web sites. We provide these links because they contain additional information that may be useful or interesting and is consistent with the intended purpose of Marketplace.cms.gov. We cannot attest to the accuracy of information provided by these third-party sites or any other linked site. We are providing these links for your reference. Linking to a non-Marketplace.cms.gov Web site does not constitute an endorsement by CMS or any of its employees of the sponsors or the information and products presented on the Web site. Also, please be aware that the privacy protection provided on Marketplace.CMS.gov does not apply to these third-party sites.

NEW DEEP DIVE/CMS RESOURCE: Tips on Working with the Media

The October 10, 2014 assister webinar also included tips on working with the media from the CMS Office of Communications. The tips are as follows:

• Prepare, prepare, prepare. Feel free to ask questions before the interview and after. If you don’t ask, you will not know. For example, set the parameters before you agree to an interview, ask for the questions in advance, and know what you want to say during the interview. Prepare answers for some of the more difficult questions you think you may be asked.
• Be prepared to answer difficult questions. If you are asked a question that should be directed to another organization or person, explain why you can’t answer the question and encourage the reporter to reach out to the organization or person. You can direct reporters to Press@CMS.hhs.gov or 202-690-6145 for inquires related to CMS.
• Remember that nothing is “off the record”. Don’t say anything you don’t want to read in the newspaper or see on the news before, during or after the interview.
• Review the clip(s). If there is a mistake in the story and you feel it should be corrected, call or email the reporter/editor and ask for a correction.

In addition to these tips, the CMS Office of Communications has produced the Marketplace Assister Earned Media and Promotion Toolkit. This toolkit provides strategies and templates for use in outreach to media and your community in order to drive traffic to Marketplace assisters as well as community enrollment events.

• To view the toolkit, use this link: http://marketplace.cms.gov/technical-assistance-resources/marketplace-assister-toolkit.pdf

NEW RESOURCE FOR RENEWAL PROCESS: 5 Steps to Staying Covered

To help consumers better understand the renewal and re-enrollment process, last week CMS released the 5 Steps to Staying Covered to make it as simple as possible for consumers to choose the plan that best fits their needs and budget. The consumer-tested 5-step process includes:

1. Review: Plans change, people change. Consumers should review their coverage and look for a letter from their plan about how their benefits and costs may change next year.
2. Update: Starting November 15, consumers should log in and update their 2015 application. Consumers should make sure their household income and other information is up-to-date for next year.
3. Compare: Consumers should compare their current plan with other plans that are available in their area.
4. Choose: Consumers should select the health plan that best fits their budget and health needs.
5. Enroll: The Marketplace opens on November 15. Consumers should make sure to review, update, compare, and choose a plan by December 15 to have any changes take effect on January 1. They should contact their plan after they’ve enrolled and make sure they pay their first month’s premium.

The first piece of this education material is available at Marketplace.CMS.gov here. CMS will continue to adapt and modify its efforts to reach existing Marketplace consumers over the next few weeks and months, using a wide range of outreach strategies including directly through mail, email, digital marketing efforts, and calls. We will continue to share these materials with you as they become available.

Marketplace Begins Sending Consumer Notices about the Renewal and Reenrollment Process

Assisters should encourage consumers that are currently enrolled in QHPs to come back to the Marketplace at the start of Open Enrollment on November 15, update their 2015 application, and compare their options to make sure they enroll in the plan that best meets their budget and health needs for next year. And, of course, assisters should encourage uninsured consumers to come to the Marketplace so they can enroll in coverage for which they are eligible, whether it is a QHP or Medicaid.

It’s important for you to be aware of the notices that consumers may get from the Marketplace so that you can help consumers understand them. CMS recently posted the Federally-facilitated Marketplace Model Open Enrollment and Redetermination notices – in English and in Spanish – which consumers will receive from the Marketplace. The model notices are available on the Marketplace.cms.gov website on the Technical Resources page under “Marketplace Open Enrollment and Annual Redetermination Notices.” To view the Marketplace notices, visit: http://marketplace.cms.gov/technical-assistance-resources/training-materials/training.html.

Below is a list of the Marketplace Model Open Enrollment and Redetermination Notices that can be found on the Marketplace.cms.gov website in English and Spanish:

• Marketplace Model Open Enrollment and Annual Redetermination Notice–Enrolled but not getting a tax credit or help with costs
• Marketplace Model Open Enrollment and Annual Redetermination Notice-‐Eligible but not enrolled
• Marketplace Model Open Enrollment and Annual Redetermination Notice-‐Updated Tax Information Shows Income too High to Continue Help with Costs
• Marketplace Model Open Enrollment and Annual Redetermination Notice-‐Tax Information Shows Income
• Marketplace Model Open Enrollment and Annual Redetermination Notice-‐Marketplace Authorized to Check Tax Information with no Change in Income
• Marketplace Model Open Enrollment and Annual Redetermination Notice-‐Marketplace Not Authorized to Check Tax Information

The Marketplace began sending Marketplace Open Enrollment and Annual Redetermination Notices last Friday to consumers via the mail or their Healthcare.gov accounts, depending on their communication preferences. These notices explain the renewal process and how consumers can return to the Marketplace between November 15, 2014 and February 15, 2015 to update their application, shop for the plan that best meets their budget and health needs, and determine if they are eligible for financial assistance for 2015 coverage that begins as early as January 1, 2015. If consumers do not return to the Marketplace to update their application by December 15, 2014, they may be auto-enrolled in the same plan—with the same amount of advance payments of the premium tax credit and same cost-sharing reductions—as they had in the 2014 plan year. However, the overall premium of the plan may increase somewhat, so the monthly amount paid by the consumer may increase even though they are eligible for the same amount of APTC. If after re-enrolling or being auto re-enrolled, consumers realize that they want a different plan, they can change plans during Open Enrollment through February 15, with coverage in their new plan starting on the first day of the next month or second following month depending on when they enroll. HealthCare.gov has been updated to reflect this information with a new page on “Keep or change your plan: 2015 Marketplace enrollment choices.” Assisters and consumers can find more information here: https://www.healthcare.gov/keep-or-change-plan.

As a reminder, on Thursday, October 2, CMS shared information about the renewal and re-enrollment process for 2015, including how assisters can help returning enrollees navigate the process for 2015 coverage and information on the notices that 2014 Marketplace consumers will receive from their issuers and from the Marketplace. The PowerPoint presentation used during this webinar is available on the CMS Technical Assistance Resources page within the “Eligibility & enrollment resources” category; please use the following link to access it:

• Assisting Consumers with the Renewal and Reenrollment Process for 2015: http://marketplace.cms.gov/technical-assistance-resources/renewal-reenrollment-process.pdf

CMS Outreach Materials of the Week: Women and the ACA

Last week, HHS released a new HHS Blog, Empowering Women Through Affordable Health Coverage, about women and the Affordable Care Act, citing real stories from women across America who are taking control of their health and becoming empowered to pursue their passions because of the law.

• “Being covered means everything to me.” – Yvonne Jones
• “I’ve launched my small business and can focus on expanding it because I now can afford health coverage for my entire family.” – Betsy Furler

Here is sample content you and your partners can share via your online platforms:

Twitter
RT @HHSgov: The #ACAisWorking for women – empowering them to take control of their health. http://1.usa.gov/1ugikkw #GetCovered
• The ability to get affordable, quality coverage is changing the lives of women like Betsy. http://1.usa.gov/1vng7b9 #GetCovered
• The #ACAisWorking to help millions of women access affordable, quality health care. Join them and #GetCovered. http://1.usa.gov/1vng7b9
• Join Betsy, Lynn, and others and take control of your health. Open Enrollment begins 10/15. http://1.usa.gov/1vng7b9 [IMAGE: betsy-furler]

Facebook
• The ability to get affordable, quality coverage is changing the lives of women like Betsy. http://1.usa.gov/1vng7b9 #GetCovered [IMAGE: betsy-furler]
• The ability to get affordable, quality coverage is changing the lives of women like Yvonne of Philadelphia. http://1.usa.gov/1vng7b9 #GetCovered [IMAGE: yvonne-jones]
• The #ACAisWorking for women. Join Betsy, Lynn, and others and take control of your health. Open Enrollment begins October 15th. http://1.usa.gov/1vng7b9 #GetCovered [IMAGE: betsy-furler]

NEW REPORT: Medicaid and CHIP Enrollment Grows by 8.7 Million Additional Americans

On Friday, HHS released the latest Medicaid enrollment report, which shows approximately 8.7 million additional Americans now have coverage through Medicaid and CHIP, many for the very first time. Medicaid enrollment grew to more than 67.9 million in August 2014, which shows nearly a 15 percent increase over the average monthly enrollment for July through September 2013. For more information please check out: http://www.hhs.gov/healthcare/facts/blog/2014/10/medicaid-chip-enrollment-august.html.

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Health Promotion Workshops Available in Spanish

The HHS Office of Disease Prevention and Health Promotion’s Eat Healthy – Be Active workshops are now available in Spanish. Each workshop promotes evidence-based health information and learning materials for Spanish speaking consumers to make informed decisions related to nutrition and physical activity and maintain a healthy lifestyle. Materials are designed for people with limited health literacy. Order “Eat Healthy—Be Active” workshop materials in Spanish and English.