1. Assister Help Resource Center

We are pleased to announce the upcoming launch of the Assister Help Resource Center, a pilot project to test and provide an assister “help desk” during the individual market Open Enrollment period for the 2015 plan year.  CMS is conducting this pilot project in an effort to improve assister-support services, and to respond to assister community feedback on lessons learned from the enrollment process during the first individual market Open Enrollment period.  Assisters cited the need for a dedicated resource center that could provide timely technical guidance, information, and solutions to resolve complex application and enrollment issues that assisters encountered during efforts to help consumers enroll in a qualified health plan (QHP), Medicaid, or the Children’s Health Insurance Program (CHIP).  

The pilot Resource Center will serve as a centralized, complementary service to the Marketplace Call Center to provide support to assisters in their efforts to help consumers with complex issues related to applications, eligibility determinations and redeterminations, and re-enrollment. The pilot Resource Center will be available to Navigators and Enrollment Assistance Program (EAP) assisters in North Carolina, Louisiana, and Pennsylvania, in a phased approach for the upcoming Open Enrollment period. Navigators and EAP assisters in these states will still look to the Marketplace Call Center as their primary source of support, but the AHRC will be available to them as a secondary resource for cases which the Call Center is not able to address.

The Resource Center will begin by serving Navigators and EAP assisters in North Carolina at the beginning of Open Enrollment in November, followed by Louisiana in December, and Pennsylvania in January.  This pilot program will help give CMS timely awareness of complex issues that consumers encounter in the enrollment process, will provide us the opportunity to share issues and resolutions with all assisters, through guidance, trainings, and established communications such as assister listservs, newsletters, and webinars.

We understand that many of you would like to participate in this pilot, and we ask for your patience as we work towards that goal. CMS has collected many lessons learned from the initial Open Enrollment period, including the value of incrementally phasing-in functionalities and processes prior to expanded implementation. Thus, it is critically important that we begin with a smaller project so that we can learn the best way to serve all assisters in the future.

2. NEW CMSzOne Community Online Resource Library Pilot for Marketplace Assisters

CMS invites you to take advantage of a new online resource that will allow assisters and other stakeholders to share materials developed to support consumers applying for and enrolling in Marketplace coverage, particularly resources in languages other than English. The Online Resource Library for Assisters is housed at CMSzONE, a social platform for organizations and individuals collaborating with the Centers for Medicare & Medicaid Services on initiatives such as outreach during the Marketplace Open Enrollment period.  To access the platform, use this link: https://zone.cms.gov/. The library will serve as a resource to allow you to see and share materials and learn about initiatives that other assisters and stakeholders have developed to promote enrollment. For example, you can use the community to look for ideas for a flyer for an outreach event, share a new presentation on the ACA, or share a multi-lingual media advisory your organization created for open enrollment.   We’ll also discuss this resource during this Friday’s assister webinar, including information on how assisters and consumer advocacy groups can sign up, so stay tuned. If you have questions, you can email assisterlibrary@cms.hhs.gov.  

1. Obtaining Consumer Authorization and Handling Consumers’ Personally Identifiable Information (PII)

As previewed on the Friday, November 7, 2014 assister webinar, CMS released a number of guidance documents for assisters related to handling consumer’s personally identifiable information (PII), including draft model consumer authorization (or consent) forms.  Please review this guidance carefully, as it will help you and your assister organization better understand how to interpret and apply the privacy and security requirements to your work. The guidance also includes “best practices” for how to keep consumer information private and secure when performing your duties.

Please note that the model consumer authorization forms are drafts and subject to change; nonetheless, you may adopt the draft model forms immediately to ensure that you have consumers’ expressed consent. If you want to modify the form, please refer to the consumer authorization tip sheet (located at the second link below) to understand what information must be included, at a minimum, on the modified form.

The following documents are available on the Marketplace.cms.gov website:

  1. NEW Guidance: How to obtain a consumer’s authorization before gaining access to PII (tip sheet). https://marketplace.cms.gov/technical-assistance-resources/obtain-consumer-authorization.pdf
  2. NEW Guidance: CAC draft model consumer authorization form. https://marketplace.cms.gov/technical-assistance-resources/draft-authorization-form-for-cacs.pdf
  3. NEW Guidance: Navigator draft model consumer authorization form. https://marketplace.cms.gov/technical-assistance-resources/draft-authorization-form-navigators.pdf
  4. Slide presentation, “Assister Guidance: Obtaining Consumer Authorization and Handling Consumers’ Personally Identifiable Information (PII) in the Federally-facilitated Marketplaces (FFMs).” [Still to be posted.]
  5. NEW Guidance: Best practices for handling PII: Fast Facts for Assisters. [Still to be posted.]

2. NEW: Model Marketplace Notices Posted

We recently posted sample Federally-facilitated Marketplace notices for data matching, auto enrollment confirmation, eligibility determinations, and the 1095-A cover page to our Marketplace.cms.gov website under “Training,” here: https://marketplace.cms.gov/technical-assistance-resources/training-materials/training.html.

Automatic Enrollment Confirmation Messages: English – Spanish

Health Insurance Marketplace Call Center: For customer service support, to start or finish an application, compare plans, enroll or ask a question.
1-800-318-2596 (TTY: 1-855-889-4325).  Available 24/7. Closed Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas.

SHOP Call Center: For customer service support, including assisting employers and employees apply for and enroll in SHOP.
1-800-706-7893 (TTY: 711).  Available M-F 9:00am-7:00pm ET.  From November 15, 2014 -December 31, 2014 open on weekends from 9:00am-5:00pm

We want to reiterate the appreciation that Marketplace CEO Kevin Counihan expressed on Friday’s assister webinar and thank you for your hard work and your commitment to your communities.  Millions of Americans need and value your persistence, patience, and kindness in supporting them through the eligibility and enrollment process.  

In just one year under the Affordable Care Act, 10.3 million uninsured Americans have gained access to quality, affordable health care. Saturday marked another milestone for the Health Insurance Marketplace as Open Enrollment begins for a second year, and we are off to a great start. In the first eight hours, more than 23,000 people submitted an application. Over the weekend, more than a million people visited HealthCare.gov and CuidadodeSalud.gov to learn about their options, shop for affordable plans or to get enrolled. Since it launched, 1.2 million people have shopped for coverage using our new window shopping tool. In addition, our Call Center took more than 200,000 calls this weekend. Over 20,000 of those calls were with our Spanish-speaking representatives.Even with the successful start of this Open Enrollment, we will continue to work to improve the consumer experience and apply lessons learned.

The vast majority of users are having a smooth experience during the first days of Open Enrollment on HealthCare.gov as they fill out applications and browse and enroll in plans. We are also hearing encouraging reports from the field where enrollment events are occurring nationwide.  Numerous media outlets have reported on the ease of using HealthCare.gov, including The Washington Post, which said “HealthCare.gov opens without major problems for second enrollment period” and CNN which wrote “Obamacare 2.0 kicks off without a hitch.” Several outlets, including the New York Times (NYT) and Reuters, also reported that “thousands of people turned up for hundreds of enrollment events around the country at public libraries, churches, shopping malls, community colleges, clinics, hospitals and other sites.”(NYT)

We may only have half the time compared to last year’s Open Enrollment, and an added challenge of renewals, but we’re confident that together with your help we can work twice as hard in reaching our goal of giving Americans access to the quality, affordable coverage they deserve. Thank you for the critical role you play, and we appreciate your hard work helping individuals enroll in coverage.  Keep up the energy and let’s start off this year’s Open Enrollment strong!   

NEW BLOG by Secretary Burwell: The Marketplace is Open!
Join the millions of Americans who now have access to quality, affordable coverage: sign up today!

#ReadySetEnroll Updates

RT Sylvia Burwell ‏@SecBurwell
The Marketplace is open – sign up for 2015 health care coverage TODAY! Visit http://healthcare.gov  for more #GetCovered#ReadySetEnroll

RT The White House ‏@WhiteHouse
Spread the word: You can sign up for health coverage starting today → http://go.wh.gov/uoSQUC #GetCovered#ReadySetEnroll

RT Sylvia Burwell ‏@SecBurwell
What you need to know about the Marketplace and how to #GetCovered for 2015: http://www.hhs.gov/blog/2014/11/15/the-marketplace-is-open.html …. #ReadySetEnroll

RT HHS.gov ‏@HHSGov
The Health Insurance Marketplace is open! Sign up for 2015 coverage today! http://healthcare.gov #ReadySetEnrollhttp://youtu.be/o4DmFR2_Mps 


#GetCovered Updates

RT Sylvia Burwell ‏@SecBurwell

#GetCovered update: @HealthCareGov opened for business shortly after 1am. In first 8 hrs, 23K+ people submitted an app. #ReadySetEnroll

RT Sylvia Burwell ‏@SecBurwell
More #GetCovered News: 1.2M unique visitors shopped for coverage last wk using our new window shopping tool. #ReadySetEnroll 


Sylvia Burwell @SecBurwell
This weekend people across the country started learning about their affordable health care options. #ReadySetEnroll#GetCovered

Sylvia Burwell  ‏@SecBurwell
#GetCovered Update: 1M+ people visited @HealthCareGov & @CuidadoDeSalud to learn about their options, shop for plans or get enrolled.

Sylvia Burwell @SecBurwell
Our call center took 200K+ calls this weekend and over 20K of those calls were to our Spanish speaking representatives. #ReadySetEnroll 

Sylvia Burwell ‏@SecBurwell
More #GetCovered News: 1.2M unique visitors shopped for coverage last wk using our new window shopping tool. #ReadySetEnroll


Know Your Rights – A Guide For Consumers Navigating Health Care

The HHS Office for Civil Rights (OCR) helps consumers understand their civil rights and right to the privacy of their health information. OCR has recently posted a resource to help you communicate this important information to consumers.

Spanish Language Instructions Available for Federal Assister Training

As we announced on the October 31, 2014 assister webinar and in the November 4, 2014 assister newsletter, the 2015 Assister Training is now available in Spanish; you can access both the Spanish and English assister training curriculum on the MLN website using the following link: http://Marketplace.MedicareLearningNetworkLMS.com.

This week, the assister training instructions are also available in Spanish on Marketplace.cms.gov. The instructions include the process for selecting a User Type/User Role, Primary Language, and enrolling in a curriculum.

HRSA Outreach in Rural Communities: Presentation Slides

The Friday, October 17 assister webinar featured a presentation by the Health Resources and Services Administration (HRSA) on best practices for reaching out to individuals in rural communities and helping them apply for coverage through the Marketplace. A summary of this presentation, along with a list of additional resources, was included in the October 21, 2014 assister newsletter. Please note that the presentation slides for this webinar are now available at the following link.

HRSA Outreach to Individuals Living with HIV/AIDS: Presentation Slides

The Friday, October 31 assister webinar featured a presentation from the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau on how to help consumers living with HIV/AIDS during Open Enrollment. A summary of this presentation, along with a list of additional resources, was included in the November 4, 2014 assister newsletter. Please note that the presentation slides for this webinar are now available at the following link.

Application Spotlight on the Assister ID Number: Power Point Slides

On the Friday, October 31 assister webinar, CMS provided an application spotlight on how the Federally-facilitated Marketplace and State Partnership Marketplace applications capture an assister’s ID number.


Assisters may now order “From Coverage to Care” (C2C) materials online in English and Spanish. C2C is the initiative from the Centers for Medicare & Medicaid Services (CMS) designed to help people with new health coverage understand their benefits and connect to primary care and the preventive services that are right for them. Print resources now available to order in English and Spanish include the full Roadmap booklet, booklets by individual step, Discussion Guide, poster size Roadmaps,  a CD on  “Road Map Steps Video Loop,” and one-page consumer tools.

In addition to new Spanish language materials, C2C video resources are now available.  Assisters may order DVDs of the 11-part video series “Road Map Steps Video Loop: Coverage to Care” (11848-CD) in English and Spanish, which walks consumers through the Roadmap and explains what health coverage is and how to use it to get needed care.

Assisters can also view and share a new From Coverage to Care PSA featuring MLS player Eric Ávila, “From Coverage to Care to a Healthier You.” This 30-second spot can be used during Open Enrollment to encourage consumers to ‘Get in the Game’ and enroll in coverage. The video is in Spanish with closed captions (in English). It is available on CMS’ YouTube channel here: https://www.youtube.com/watch?v=Syzj9zed8NI&feature=youtu.be

To order resources, you will need to create an account on the CMS product ordering website. To do so, please go to http://productordering.cms.hhs.gov and select “create an account.” There will be a text box at the bottom of the account creation form titled, “Why I need access? (Explain in 250 words).” In this section, please include a brief description of the organization for which you work that indicates why you plan to order CMS materials (for example, “ABC Partnership Group,” an advocacy group of seniors with diabetes). This information will allow us to properly process the request. CMS will grant approval of the account within three business days, after which you can log in to order products. Please note that your account won’t be accessible until your access is approved. You will receive an email notice of approval and then you may log in.

As we have noted in past newsletters, we also encourage assisters to:

To download and print your own booklets, go to http://marketplace.cms.gov/c2c. When printing your own booklets, select a file and change your printer to “booklet” setting before printing. Files will print on standard 8.5 X 11” paper.


The countdown to the Marketplace Open Enrollment continues. Here are new resources that we hope are helpful to you in your outreach efforts.

Marketplace Widgets: 

Including two newly created widgets for the Window Shopping Tool

English: https://marketplace.cms.gov/outreach-and-education/mp-badges-english.html

Spanish: https://marketplace.cms.gov/outreach-and-education/mp-badges-spanish.html (Spanish widgets expected to post this week. Please check back later in the week)

5 Steps to Staying Covered Promotional Materials:

To stay covered through the Marketplace for 2015, consumers need to follow 5 Steps during Open Enrollment.

Images and Promotional Materials:

Image: 5 Steps to Stay Covered (Small)

Image: 5 Steps to Stay Covered (Medium)

Image: 5 Steps to Stay Covered (Full)

Brochures: English | Spanish

Fact sheets: English | Spanish

Infographics: English | Spanish

Postcards: English | Spanish

Posters: English | Spanish

Drop in article: Take Action to Stay Covered through the Marketplace in 2015


RT @SecBurwell: https://twitter.com/SecBurwell/status/530750470059724800

Did you #GetCovered last year? Here are the 5 Steps you need to take to stay covered this year: http://1.usa.gov/1x3Ez1M

#GetCovered? Stay covered with these 5 steps: http://1.usa.gov/1x3Ez1M

SHARE: 5 Steps to Staying Covered Through the Health Insurance Marketplace: http://1.usa.gov/1x3Ez1M

Did you #GetCovered last year? Time to review, update, compare, choose and enroll! http://1.usa.gov/1x3Ez1M

Korean Language Marketplace 101 Videos:

We’ve launched two videos on YouTube in the Korean language targeting uninsured Koreans living in the US. We hope these videos will help Korean Americans learn more about the Marketplace.

English Title: Health Insurance Marketplace Literacy

Korean Title: 마켓플레이스의료보험이해력

URL: http://youtu.be/OnGtrZRYRvE

English Title: Health Insurance Marketplace 101

Korean Title: 마켓플레이스의료보험이란?

URL: http://youtu.be/qlPwvruSrao

HHS News:

The Secretary in the News:  Secretary Burwell traveled to Philadelphia to speak with consumers and local health care stakeholders about the Open Enrollment period beginning on November 15. The Secretary was joined by individuals who purchased health care coverage in Pennsylvania last year during Open Enrollment and who emphasized the importance of getting covered. Use the following link to read about Anne, a young woman grateful to have purchased health insurance through the Marketplace shortly before receiving an unexpected cancer diagnosis: Anne’s I’m Covered Story: Insuring Against the What-Ifs 

Beginning this week, consumers can visit the HealthCare.gov window shopping tool to review information on health insurance plans offered in their area, including information on covered benefits and physician and hospital networks.  There are  more plans on the market this year than there were last year.  After answering a few questions, such as place of residence and family size, consumers can compare plans and get an estimate on how much financial assistance they may qualify for before submitting an application.

  • This year consumers are able to email, share a link to a plan, and print information so they can review options when and where it’s convenient for them.
  • Window shopping has been optimized for smart phone and tablet use.
  • Premium estimates are more accurate thanks to more robust data. For example, tobacco rates are included in the tool.
  • It’s important that current Marketplace enrollees also review new plan options. Every year insurance companies make changes to premiums, cost-sharing and benefits; also, new plans are being offered in 2015.

To preview plans in your area, visit: https://www.healthcare.gov/see-plans/.

To view the press release on the window shopping tool, visit: http://cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-11-09.html

The next NURSE Corps Loan Repayment Program (LRP) Application Cycle is expected to open in January 2015. To expedite the application review process, potential applicants and facility administrators are encouraged to have the eligibility of their current facility location reviewed for participation in the NURSE Corps LRP Eligible NURSE Corps sites or Critical Shortage Facilities (CSFs) are defined as a health care facility located in, designated as, or serving a mental health or primary medical care Health Professional Shortage Area (HPSA).

Potential applicants and facility administrators may submit their facility information to CSF_Request@hrsa.gov beginning November 6 through December 2, 2014. Notification of facility eligibility will be confirmed by December 31, 2014 via email.

When submitting a health care facility to the NURSE Corps LRP for consideration, please provide the following information:
1. Name of the facility and its specific location (i.e., satellite facility cannot use main facility address)
2. Full mailing address of the facility including street address, City, State, and Zip code (Do not use P.O. Box)
3. Facility profit status; Refer to pages 8-9 of the 2014 NURSE Corps LRP APG for a complete list of eligible facilities.

If you have any questions about this process, you may contact our Customer Care Center at 1-800-221-9393 Monday through Friday (except Federal holidays), 8:00 a.m. to 8:00 p.m. ET.

CMS Renewal/Re-enrollment webinar
November 12th at 11am CST

To join: https://webinar.cms.hhs.gov/cmsregion7partnertraining/
1-877-267-1577 Meeting Number: 998 569 185

This webinar will contain much of the same information presented by the National CMS/CCIIO group, but this webinar will allow all assisters to ask their specific questions related to renewals/redeterminations.