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GEAR Newsletter

The Final Days of OE3!

It’s the final days of Open Enrollment!Don't get left out Everyone has been working hard and the final push is here. We know that all of your focus right now is helping consumers at the last minute, so we’ll keep this week’s newsletter brief. Help Consumers Think about Their Plans before Their Appointment                  EA_Logo_RGB We know that this last week has been full of enrollment appointments and you likely have consumers lined up to meet with you. Often times the longest part of the process is the plan selection at the very end. One way to help streamline this process and give consumers something to do while they’re waiting is to have them visit Enroll America’s Get Covered Plan Explorer. This tool helps consumers to better understand key features of their health plan choices like what they will pay out of pocket for health care services in a given year, and what doctors are covered. It also allows consumers to look at plans before they have even created a healthcare.gov account. Resource Highlight – Health Coverage and Taxes tool from Healthcare.gov This new tool from healthcare.gov combines the lowest cost bronze plan (LCBP) and second lowest cost silver plan (SLCSP) look-up features in one tool. This should make it easier for consumers when they are filing their taxes if they received a premium tax credit or are applying for an affordability exemption. New Marketplace Resources New SEP Guidelines – CMS Blog Tax Resource Hub – In the Loop #Heretohelp Campaign – HHS and In the Loop MORE >

The Final Enrollment Push

Enrollment Video for Consumers


Do you work with consumers that more information on the enrollment process? Do you need a tool for outreach while consumers are waiting for an appointment? Check out GHF’s “Getting Covered During Open Enrollment” with our enrollment assister, Pranay Rana. It’s a great piece to add to your tool box.

The Final Enrollment Push

There are less than two weeks left in Open Enrollment and the final push is coming. If this year is anything like the previous OE’s, there will be a big rush of consumers during the final days. Make sure you talk to your consumers about the deadline (Jan. 31) and educate them on all of the materials they need for open enrollment. Nothing is more frustrating for you and the consumer than having them come to you in the final days of open enrollment, but not having all of the materials they need. Here is a great resource to remind consumers what they need to bring with them to an enrollment appointment:

[embeddoc url=”http://ghf.jasonaxelson.com/wp-content/uploads/2016/01/ET01_ApplicationGuide.pdf”]Resource Highlight – Marketplace Assister Newsletter Archive from In the Loop

During Open Enrollment while you’re focused on consumer appointments, outreach opportunities, and other enrollment tasks, it’s hard to stay on top of emails, new resources, webinars, etc. If you receive the CMS weekly assister newsletter, you may just scan it and then hit delete or let it fall to the bottom of your in box while you try to manage all of your other emails. However, those emails are often times full of great information that you may find out you wish you had known about during OE. Fortunately, our friends over at In the Loop understand this and have created an archive of all the assister newsletters. Now you can go back and look through them for any missed info, such as the Assister’s Roadmap to Resources and all of their archived webinars. Click here to go to the In the Loop archive.

New Marketplace Resources

Getting Ready for Tax Season blog – CMS

Report on enrollments for the first part of 2016 open enrollment – HHS

“The Who’s Who of Complaints, Appeals, and Casework: Deluxe Edition” – In the Loop

Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to wgriggs@healthyfuture.org and let us know!


New Way to Access GEAR

Check Out the New GEAR Page!

Georgians for a Healthy Future is excited to announce the launch of our new website, and along with it, the new GEAR page. The pages have new lay outs and features, which will make navigating them and finding what you are looking for even easier. You can still find our home page at healthyfuturega.org and the GEAR page healthyfuturega.org/gear. Go ahead, check it out and let us know what you think. As always, if there is something that you think that should be on the GEAR page that isn’t there now, let us know!

gear page image

Still Not a Member of In the Loop? Join to Get Their Best Practices of The Day Emails

As we’ve mentioned before, In the Loop is a great resource for enrollment assisters. Being a part of the In the Loop Community allows you to interact with other enrollment assisters from around the country, learn best practices, share trouble shooting tips and more. Need another perk to get you to join? In the Loop also sends out daily emails with their best practices of the day from fellow enrollment assisters. These emails provide you with tips and tricks to make enrollment a lot easier and smoother. Often times their suggestions are things you might not have even thought of before. So if you still need to join In the Loop*, click here.

* In the Loop is only for enrollment assisters and other enrollment stakeholders, in order to keep it a place where people can confidently share information. As such, In the Loop does require registration and approves each person that wants to join.


Resource Highlight – “How Premium Tax Credits Work” Video from Healthcare.gov

The video helps consumers understand how the financial assistance they received through their advanced premium tax credits will be reconciled when they file their taxes. The video is also available in Spanish.

New Marketplace Resources

Taxes and the Health Insurance Marketplace – healthcare.gov

SHOP Basics and 2016 Updates webinar – CMS

Ledger to Calculate Income for Self-Employed Consumers – In the Loop


Happy New Year + A Special Announcement


Happy New Year from GEAR and Georgians for a Healthy Future!

2016We hope that everyone had a happy, healthy and relaxing holidays! Congratulations on all of the hard work you have done for the past two months helping over half a million Georgians enroll in coverage. There’s a little less than a month left of open enrollment and we’re GEARing up for the final push!





Special Announcement!

Join us for the ACA Stakeholder call today at 1pm with Kevin Counihan, CEO of healthcare.gov! We want to make sure that Georgia is well represented with a strong attendance. We know that everyone is busy, but this is a great chance to connect with a top official. Click here to  register for the call.



Shout Out to Georgia’s Rock Star Assisters!

Congratulations to Amalia Benvenutti and Amber Higgins from InsureGA for being among In the Loop’s “Looper Rock Stars”! The rock stars are nominated by fellow In the Looper’s for going above and beyond the call of duty. Here’s what their peers had to say about Amalia and Amber:

“Amalia goes above and beyond for her consumers and her fellow navigators. This is our first year at our organization and she’s helped over 100 consumers in Georgia. She is very knowledgeable and I couldn’t think of anyone better that deserves the honor.”

“Because Amber was one of the first regional navigators with our organization to be licensed for OE 3, she has been assigned events and tasks to assist others outside of her designated region. I am very fortunate to be colleagues with such a professional and caring person.”



Resource Highlight – Families USA’s “Follow-up: Increase Your Impact and Keep Them Coming Back” Webinar

With less than a month left in open enrollment, follow-up with consumers is especially vital to make sure people enroll and pay their premium. Families USA hosted a webinar to discuss best practices to make sure that both consumers and enrollment assisters are follow-up with each other after an enrollment appoint. We know that everyone’s time is tight, but the webinar is fairly short and very informative, so take a moment to check it out (you may even see a familiar name).


New Marketplace Resources


A Tune-Up on Eligibility Rules and Application Process for Families with Immigrants

Georgetown University Center for Children and Families


The Catalog of Assister Promising Practices



The ACA and Tax Filing for Married, Separated, and Abandoned Spouses 

In the Loop



Happy Holidays from GHF and GEAR

Happy Holidays from Georgians for a Healthy Future and GEAR

Congratulations on making it past the December 15th deadline (which really turned out to be the December 17th deadline)! We know it has been a crazy few days for all of the enrollment assisters, so we wanted to spread some holiday cheer. Watch our video below!


Five Facts for Consumers about the Fee for Not Having Health Coverage

No one likes to talk about the fee for not having health insurance, but since the 2016 penalty will be so large, it’s going to be a major motivator for consumer’s (Pro tip: Use the term “fee” instead of “penalty” – it resonates better with consumers).

Here are 5 facts about the fee that consumers need to know:

  1. The fee is calculated 2 ways, depending on the consumers situation – If a consumer goes for more than three months without coverage despite having access to affordable coverage (from their job, the Marketplace, Medicaid, Medicare, or purchased on their own) they will have to pay a fee of 2.5% of their annual income or $695 dollars. They will have to pay whichever is they higher of those two amounts, and for most it will be 2.5% of their annual income.
  2. The fee for 2016 is increasing – as noted above. Some consumers that were on the fence about enrolling the first two years decided to take the fee because it was more affordable than enrolling in coverage. That is not likely going to be the case this year because the fee is so much larger.
  3. Every month without coverage counts – The fee is calculated based on the number of months (over 3) that you went without coverage, up to the maximum fee.
  4. Some people can get an exemption from the fee – people that are unable to get a subsidy because their income is too low are exempt from the fee. Also exempt are people that are not legally in the country, people in jail, and people that went less than 3 months without coverage. Click here  for the exemption tool from healthcare.gov.
  5. If they want to avoid the fee, they need to enroll by January 31st, 2016 – CMS has released a statement that the deadline will not be extended and the SEP that was available for the April 15th tax deadline will not be available this year. So make sure your consumers know that January 31st is the LAST DAY TO ENROLL!

Important note: the maximum fee a consumer will have to pay is capped at the total yearly premium for the national average price of a Bronze plan sold through the Marketplace.

Source: CMS Blog


Cover_ImageResource Highlights: Hard Copies of the Spanish Enrollment Toolkit and Health Insurance User’s Manual

We have hard copies of our Spanish version of the Enrollment Toolkit Health Insurance User’s Manual. We have a limited amount of hard copies, but the electronic versions are available on the GEAR website. Email Whitney if you are interested in receiving hard copies.


penaltiesPenalties and Exemption Fact Sheet

Speaking of the fee, need help explaining the fee to consumers? Or want to walk someone through whether or not they will need to pay the fee? Check out GHF’s “Penalties and Exemptions” tool.


New Marketplace Resources

Updated Functionality for Immigrants Below 100% FPL


Health Insurance Literacy Resources

In the Loop

Questions to Help Consumers Choose the Right Plans

Families USA



The Deadline is Coming!

T2016he Deadline is Coming!

As you all know the December 15th deadline for January 1 coverage is quickly approaching. If you or your organization is active on social media, now is a great time to send out reminders for the deadline. It’s especially important to remind consumers that already have coverage that now is the time to shop around before they are automatically re-enrolled in the same plan from last year, which is likely to have a higher premium. Need some ideas for social media posts? Check out these social media graphics from HHS.




billboardShow Us How You’re Doing Outreach!

Georgians for a Healthy Future is collecting pictures, graphics, social media posts, etc from organizations on how they are doing outreach. Pictures could include billboards (like this one from SRA), signs you have posted out in front of your building, or anything related to how you are getting the word out about your enrollment activities. You can send your pictures or posts to Whitney.

Join Us for the Bi-Weekly Enrollment Stakeholder Call

Every other Thursday GHF and Enroll America host the enrollment stakeholder call. Attendees include HHS, Navigator grantees, and other enrollment stakeholders throughout the state. The calls are a great opportunity to learn about the work that other groups are doing and let the groups know about any events your organization has coming up. The next call will be on Thursday, December 17th at 1 pm. Click here to register for the call. 

enrollNational Resource Highlight –

Enroll America’s Six Things You Can Learn about the Uninsured Landscape in Your State

How has the uninsured landscape in Georgia changed since the Marketplace opened two years ago? Enroll America recently published individual data profiles for all 50 states and D.C. to provide enrollment assisters with the latest information on the remaining uninsured in their state. The profiles are full of data, so click here to understand more about what all that data means.

New Marketplace Resources

Health Reform Beyond the Basics, OE3 Webinar Series Recordings 

Center on Budget and Policy Priorities

Marketplace Enrollment Snapshots Week 3 of Open Enrollment


Fast Facts on Assisting Consumers Who are Immigrants (Now available in 19 languages) 


Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to Whitney and let us know!



Week 5 of Open Enrollment!

The GEAR team hopes that everyone had a happy Thanksgiving and enjoyed a slight respite from the frenzy of Open Enrollment. We are now on the 5th week of Open Enrollment and it sounds like there is still a lot of interest from consumers looking to re-enroll in a plan from last year or shop around to see if they can find a new plan.

Save the Date: Join Us for a Webinar with FamiliesUSA

Families-USAFamiliesUSA will be hosting a webinar on best practices for post enrollment follow-up on December 10th at 2pm. It will be a great opportunity to learn about what enrollment assisters from around the country are doing to follow-up with consumers after they enroll. The webinar will also include a presentation from Whitney Griggs from Georgians for a Healthy Future and Jamila Young from Grady Health System. Use this link to register.



We Have Some Homework for You (Don’t worry, it’s just for fun)!

If you attended the Getting and Keeping Georgia Covered event in October, you may remember this from Don Rubin’s presentation on health literacy. We have two separate activities to help you think through ways to be more health literacy-friendly. If you complete both activities and send them to Whitney by the end of the week (December 5), we’ll send you a prize!

•  Activity 1: Think Outside The Box
•  Activity 2: Draw This  

Enroll-AmericaNational Resource Highlight – Enroll America’s Get Covered Plan Explorer

Enroll America’s new free resource, the Get Covered Plan Explorer, allows consumers to find a health plan that fits their health care needs and their budget as well.

New Marketplace Resources

Five Facts about PII (Personally Identifiable Information)
In the Loop

Supporting Enrollment Needs for People Living with HIV

Webinar: Overview of Immigrant Eligibility Policies and Application Processes for Health Insurance Affordability Programs
Healthcare Reform Beyond the Basics, CBPP

Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to wgriggs@healthyfuture.org and let us know!  


Week 3 of Open Enrollment!

As we close in on week 3 of open enrollment, it looks as if some enrollment trends are starting to emerge. From what we’ve heard at GHF it sounds like more repeat consumers (re-enrollments) are looking to help from enrollment assisters and that consumers are coming to appointments armed with more information. Does this sound like what you have been encountering as well? Has your experience been different? Email Whitney and let us know!

Do You Know About AHRC?

The Assister Help Resource Center (AHRC) is a dedicated call center for Navigators and CACs. AHRC provides information and solutions for resolving complex application and enrollment issues. Specifically AHRC can help enrollment assisters with:

  • Immigration, mixed status households, immigration status
  • Medicaid and CHIP as they relate to the Healthcare.gov states
  • Documents and information needed for ID proofing / verification
  • Income and eligibility
  • Enrollment process
  • Exemptions
  • Special enrollment periods (SEPs)
  • Issues with 1095-A
  • Reporting life changes
  • Tips for avoiding or resolving data matching issues

Enrollment assisters can access the AHRC by calling 1-855-811-7299 starting Monday, November 2, 2015.  The AHRC is open Monday through Friday from 9am to 9pm EST and Saturday from 9am to 5pm EST during Open Enrollment for the individual market.

NOTE: AHRC can only be used by licensed enrollment assisters (CACs and Navigators). If you are not a licensed enrollment assister but know a consumer who needs help with a complex issue, get in touch with your nearest enrollment assister for help.

National Resource Highlight – CMS’ Assisters Roadmap to Resources

The Roadmap is a quick guide to the resources the Centers for Medicare & Medicaid Services (CMS), and other federal partners have developed to help assisters and consumers navigate the Health Insurance Marketplace. The topics covered include:

  • How to get the latest information on Marketplace policies and operations from CMS
  • What coverage options are available to consumers
  • What you need to know about the Marketplace enrollment and eligibility process to help consumers get coverage
  • How to access Marketplace information and resources in other languages

New Marketplace Resources

Consumer Guide for Annual Household Income Data Matching Issues

Giving Thanks: Caring For the Health of our Rural Communities and Congregations
The Partnership Center

Three Steps to Stay Covered
Enroll America

ICYMI – Press conference held highlighting free enrollment and post-enrollment materials

FWHC Press Conference 11.15Georgians for a Healthy Future and several other local partner organizations participated in a press conference to highlight new materials and resources that are available to consumers. Click here to learn more about the press conference and the materials highlighted. Thank you to Feminist Women’s Health Center and Ebenezer Baptist Church for hosting the conference!



Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to wgriggs@healthyfuture.org and let us know!


Two weeks into Open Enrollment!

We are almost two weeks into Open Enrollment and everything seems to be going smoothly. We’ve heard from some of our partners that OE3 started off a little slow (seems like the rain may have kept people away) but that a few days in things really started to pick up. Consumers from last year also seem to be very interested in making appointments with enrollment assisters to shop around for 2016 plans. Has this week been the same? What have been your successes and challenges of the past two weeks? Let us know!

FYI: Healthcare.gov Updates
Issues with the Cost Calculator are being addressed: You may have noticed some problems with the Cost Calculator tool when working with consumers. Most of these problems have been fixed, but there are still a few to work out.
  • If you are working with a consumer and are having issues with the Cost Calculator, take them to the Get Covered Calculator. Research has shown that consumers greatly benefit when they understand all of the costs related to purchasing health insurance.
Healthcare.gov is beta testing two new tools: a “Doctor Lookup” and a “Prescription Drug Check” feature added to the website. Both of these tools will be pilot tested with randomly selected users over the next few weeks. Click here to learn more.

Join us for ACA Stakeholder calls!

Every other Thursday (see schedule below) during Open Enrollment, GHF and Enroll America will be hosting Stakeholder calls to go over updates from various enrollment partners, including navigator grantees and partners from around the state. Click here to register for calls.

November 5 & 19
December 3, 17 & (tentative) 31
January 7 & 21
February 4

National Resource Highlight – Raising Women’s Voices’ “My Health, My Voice: A Women’s Step-by-Step Guide to Using Health Insurance”

MyHealthMyVoice“My Health, My Voice” is an initiative to help newly insured women understand their health insurance and avoid unexpected costs. The resource includes sample scripts for doctor’s visits and beautiful, but simple graphics to help consumers with low literacy. The guide is available in hard copy (which you can order from their website) and as an interactive website that you can see here.





New Marketplace Resources
Kaiser Family Foundation
ACA Spotlight (Don’t know about the Family Glitch? Click  here to learn more. It’s VERY important!)

Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to Whitney and let us know!



Happy OE3!

Happy OE3! The third round of Open Enrollment kicked off this weekend and we want to hear from you. Did your organization host an event? Was the website working well? Did you see a lot of return consumers? Tell us about your first enrollment experience! Send us an email to tell us how OE3 started off for you.

This Just In! – Spanish Language Materials

You’ve been introduced to our enrollment toolkit and our post-enrollment workbook and now we have them in Spanish!

Spanish toolkit Spanish workbook


Do you work for an organization that focuses on enrolling Spanish-speaking consumers? Let us know if you want to have these resources co-branded with your organization. It’s free!

National Resource Highlight – Georgetown University’s Health Policy Institute – Center on Health Insurance Reform’s Navigator Resource Guide

CHIR’s updated Navigator Resource Guide has searchable frequently asked questions (FAQs) and easy-to-read background information on key health insurance and marketplace issues. The guide is divided into four sections: (1) People without coverage, (2) People with coverage, (3) Employers offering coverage, and (4) Post-enrollment problems with coverage. Learn more about the guide here.

New Marketplace Resources

Consumer Guide for Annual Household Income Data Matching Issues

The Assister’s Roadmap to Resources

Talking about Premium Increases with Consumers
Community Catalyst

Tips for Helping Consumers Renew Long Distance
In the Loop (Make sure you are a member of In the Loop to view this resource)

ICYMI – “Getting and Keeping Georgia Covered”

Did you miss the “Getting and Keeping Georgia Covered” event? On October 28th, GHF and Enroll America convened a panel of experts to talk about best practices to increase enrollment and retention throughout Georgia. You can see the resources from that day here.

Do you have any resources that you use that you would like to see highlighted in GEAR? Send them to wgriggs@healthyfuture.org and let us know!