Certified Application Counselor Program Status Meeting New Dial - Conference Line: 877-431-1883 code 370 252 4147 Please MUTE your lines when not speaking (*6) Please do NOT put your line on hold April 28, 2014

Certified Application Counselor Program Status Meeting April 28, 2014

AGENDA Welcome/Introductions Medicaid Update Workflow Processes Analysis of CAC numbers Training Updates MHC Call Center Assisting Consumers Q & A

Welcome Application Counselor Sponsoring Entities! Leslie Lyles Smith MHBE Director of Operations Jody Zoeller-Hartzell MHBE ACSE Program Manager Tia Witherspoon MHBE Training Manager Debbie Ruppert Manager Medicaid Enrollment, DHMH Rita Dyer Call Center Coordinator Ginny Seyler Manager Connector Entity Program Aaron Jacobs MHBE Deputy Director of Operations

Medicaid Update

Debbie Ruppert will give updates on Medicaid Medicaid Update  Debbie Ruppert will give updates on Medicaid

Workflow Processes

Workflow Processes Special Enrollment for Life Events Link to Public Comment: http://marylandhbe.com/committees/public- comment/ Triggering life events include birth, marriage, certain types of loss of coverage, change in income, or change in citizenship. A special enrollment period can also be triggered by other circumstances, such as application or enrollment errors and carrier misconduct. A consumer will need to work with a consumer assistance worker; a self-help method will not be available initially. A consumer will report a qualifying life event to a call center representative, navigator, or other assistance worker who will then talk the consumer through the needed documentation. The consumer will then send the documentation to the call center (FAX # 855-642-8574), and the assistance worker will help the consumer complete an application and shop for a plan. Once the MHBE verifies the application and supporting documentation, and a plan is selected, the consumer’s information will be sent to the carrier.

Workflow Processes Termination of Qualified Health Plan Coverage Link to Public Comment: http://marylandhbe.com/committees/public-comment/ Enrollee-Initiated Terminations A. An enrollee may terminate his or her coverage in a qualified health plan, including as a result of the enrollee obtaining other minimum essential coverage, with appropriate notice to the Exchange or the qualified health plan. B. The Exchange will provide an opportunity at the time of plan selection for an enrollee to choose to remain enrolled in a qualified health plan if he or she becomes eligible for other minimum essential coverage but does not request termination in accordance with subsection A of this Regulation. If the enrollee does not choose to remain enrolled in the qualified health plan through the Exchange, the Exchange must initiate termination of his or her coverage upon completion of the redetermination process specified in 45 CFR §155.330.

Workflow Processes Termination of Qualified Health Plan Coverage Termination by the Exchange The Exchange may initiate termination of an enrollee's coverage in a qualified health plan, and must permit a qualified health plan issuer to terminate such coverage, in the following circumstances: A. When the enrollee is no longer eligible for coverage in a qualified health plan through the Individual Exchange, the last day of coverage is the last day of eligibility, as described in 45 CFR §155.330(f), unless the individual requests an earlier termination effective date pursuant to Section .02. B. When the enrollee has not paid the premiums for his or her qualified health plan coverage, and any available grace periods have been exhausted. 1. For individuals receiving the three-month grace period for individuals receiving advance payments of the premium tax credit pursuant to 45 CFR §156.270(g), the last day of coverage will be the last day of the first month of the three-month grace period. 2. For any other applicable grace periods, the last day of coverage will be consistent with existing State laws regarding grace periods; C. When the enrollee's coverage is rescinded in accordance with 45 CFR §147.128, the last day of coverage is the last day of the coverage month in which the coverage is rescinded; D. When the qualified health plan terminates or is decertified as described in 45 CFR §155.1080, the last day of coverage is the last day of the coverage month in which the qualified health plan is terminated or decertified; or E. When the enrollee changes from one qualified health plan to another during an annual open enrollment period or special enrollment period in accordance with 45 CFR §§155.410 or 155.420 and State policies, the last day of coverage in an enrollee's prior qualified health plan is the day before the effective date of coverage in his or her new qualified health plan. Other Termination Events. A. When an enrollee’s coverage is terminated due to death, the last day of coverage is the date of death. B. Where an enrollee is newly eligible for Medicaid or CHIP, the last day of qualified health plan coverage is the day before the individual is determined eligible for Medicaid or CHIP.

Analysis of CAC by Entities

CAC by the numbers

Training Updates

3 day Webinar Series & 1 day MHC Systems Webinar Future training dates; future testing sites 3 day Webinar Series & 1 day MHC Systems Webinar 1 additional session will be scheduled for each webinar. This will conclude CAC training. You will be notified by email when enrollment is open. Future testing Sites & Dates Timonium Session #1 : May 8th Session#2: May 9th ** This session is reserved for only those who need to re-take the CAC Exam. You will be notified via email when enrollment is open

CAC Exam Results CAC Exam Pass Rate In reviewing passing rates, it is important to remember that candidates are evaluated against an established standard of competence. First-Time Test Taker Pass Rate: 66% Second-Time Test Taker Pass Rate(less than 100 takers): Significantly Lower Because the performance of small numbers of examinees can have a significant effect on results, pass rates for examinations with less than 100 takers should be interpreted cautiously

Study the Participant Guide Dedicate extra time to study CAC Exam Tips for Success Study the Participant Guide All of the content on the exams come directly from the Participant Guide Dedicate extra time to study In addition to the training, CAC’s will need to set aside time to review the Participant Guide Be Prepared The Buddy System Partner with Application Counselor’s in the organization or community who have successfully passed the examination

What happens after 3 attempts? CAC Exam Exam Policy CAC’s can take the exam up to 3 times. The passing score is 70% or better. What happens after 3 attempts? You will be required to repeat training. You are required to wait 1 year from you last attempt to re-take the examination.

MHC Call Center

MHC Call Center The call center has a list of certified application counselors that is updated as new certifications are processed. When calling on behalf of a consumer introduce yourself by name. I am a certified application counselor and my certification # (the alpha number combination called ACSE ID: or Certified ID: on your letter) and I am calling on behalf of consumer’s name.

Assisting the consumer

Assisting the consumer Now that open enrollment is closed, there are several ways to assist the consumer: If they are low income they may be eligible for Medicaid, enrollment is year-round and coverage is retroactive to the 1st of the month they are eligible. Perform hand off to local health department, local department of social services or the Call Center. If they have had a life event that changes their circumstances with respect to insurance coverage, such as job loss, change of income or divorce, they may be eligible to enroll in QHP through a “Special Enrollment Period.” Perform hand off to the Call Center. If a consumer is already enrolled in insurance through MHC and has experienced a life event, perform a hand off to the Call Center. If you are unsure or the customer would like in-person assistance, perform a hand-off to the regional Connector Entity.

QUESTIONS ?

Contact Information Leslie Lyles Smith, Director Operations 410-547-1278 or Email: Leslie.LylesSmith@maryland.gov Jody Zoeller-Hartzell, ACSE Program Manager 410-547-8158 or Email: Jody.Hartzell@maryland.gov