1. Certified Application Counselors In Ohio
Nita Carter, Health Equity Director
UHCAN Ohio

2. Recruiting Certified Application Counselors:
What will be covered:
Overview of Navigation in Ohio
Recruiting Certified Application Counselor Organizations
Providing Technical Assistance
Legislative Advocacy
Engaging Faith and Community Based Programs in Navigation
Future Trends

3. Ohio’s Navigation System:
Navigators
Federally Qualified Health Centers
Certified Application Counselors
Cognasante
SAR
Agents and Brokers
ONCE
Regional Enrollment Assistor Tables

4. Recruiting Certified Application Counselor Organizations:
Identified Programs working in communities who should be a part of the Navigation System
Used the organizations we worked with around CTG grants and the UHCAN Ohio Health Equity Committee to help us Identify programs
Convened regular statewide conference calls to educate them on navigation under the ACA and prepare them for the navigation grants coming out.
Held CAC orientations in 4 Cities across the state.
Convened follow-up calls for those organizations who decided to become CAC’s.

5. Providing Technical Assistance to Faith and Community Based Organizations:
Regular updates on navigation process, what is working and what is not;
Provide information from the various networks and offices, (ONCE, regional assistor tables, Community Catalyst, In the Loop and CMS);
Assist with filling out CAC Applications, setting up their programs and provide sample documents and;
Available by phone to answer questions and participate by phone or in person for first enrollment.

6. Legislative Advocacy:
Engaged faith and community based programs in advocating against HB3 and SB9.
Developed testimony, draft language and participated in legislative stakeholder meetings.
Signed onto a letter asking Ohio’s Department of
Insurance to become a Consumer Assistance State
Partnership Exchange.
Developed recommendations for effective navigation in
communities of color.

7. How Are they Involved in Navigation:
Participated in the joint navigator application of the Ohio Association of Food Bank;. Became Certified Application Counselors and; Working with the Navigator Organizations in their area to host events and refer people they work with to enrollment Assistors.

8. Future Plans/Trends:
Building the infrastructure among community and faith based organizations to:
Become a part of the feedback loop on what is working and what is not with respect to enrollment, linking to care and new models of care.
Participate in future ACA implementation planning and delivery system reform .

9. Sample Training Materials
Certified Application Counselor
Sample Training Materials.

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

11. 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.

12. 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

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

14. 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.

15. Navigators Serving Ohio
Helping Hands Community Outreach Center (Dayton)
Call
Anticipated grant amount: $230,920
Neighborhood Health Association (Toledo)
Call
Anticipated grant amount: $684,630

16. Navigators Serving Ohio
Ohio Association of Foodbanks (Serving most parts of Ohio)
Call
Anticipated grant amount: $1,958,961
Clermont Recovery Ctr, Inc. (Clermont, Brown and Adams Counties)
Call Tammy Altman at
Anticipated grant amount: $44,938

17. Navigator Collaborative of the Ohio Association of Food Banks
Ohio Association 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
Disability Rights Ohio (DRO), All 88 Counties
Health Care Access Now (HCAN), Adams, Brown, Butler, Clermont, Hamilton, and Highland Counties
Heart of Ohio Family Health Center (HOFHC), Franklin County

18. Navigator Collaborative of the Ohio Association of Food Banks
Hospital Council of Northwest Ohio (HCNO), Allen, 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
United Way of Greater Cleveland (UWGC), Ashland, Cuyahoga, Geauga, Holmes, Medina, Portage, and Wayne Counties
The Community Action Program Corporation of Washington Morgan Counties (WMCAP), Morgan and Washington Counties
Western Reserve Area Agency on Aging (WRAAA), Cuyahoga, Geauga, Lake, Lorain, and Medina Counties

19. 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 updates
Include articles in your newsletter
Print materials/handouts
Invite Enroll America to your meetings
Schedule a presentation with UHCAN Ohio

20. 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.

21. How to Become A CAC
1. Find out what is required of a CAC. 2.Fill out an application on-line found at (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.

22. 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

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

28. 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.

29. 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.

30. 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

31. 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.

32. 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

33. Get The Word Out About Enrollment
Put an article in your newsletter
In your next newsletter you can drop in this article from the 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: ons-and-articles/relaunch-drop-in-article.pdf

34. 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

35. Thanks for Participating!
Nita Carter
UHCAN Ohio
x224
Kathleen Gmeiner
Ohio Consumers for Health Coverage
x223
UHCAN Ohio
Ohio Consumers for Health
@UHCANOhio
@KathleenOCHC
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