Certified Application Counselor

1. Certified Application Counselor A quick overview

2. What does a CAC Organization do? • As a CAC organization, your staff and volunteers will help people understand, apply, and enroll  for health coverage through the Marketplace. Your organization must agree to make sure that designated individuals complete required training, and that they comply with privacy and security laws, and other program standards. • Your organization must:  • Have processes in place to screen your staff to make sure that they protect consumer information. • Engage in services that position you to help those you serve with health coverage issues. • Have experience providing social services to the community.

3. How to become a CAC Organization: • The first step to becoming a CAC organization is to fill out an application at CMS.gov. When filling out the application it will ask for the contact person at the organization who is allowed to enter into contracts on behalf of the organization. • Once being accepted, the designated individual will receive a contract from CMS. • The individual will then read, sign and return the contact sent to your organization. • You have the right to withdrawal your participation as a CAC organization at any time in writing to CMS.

4. How to become a CAC: • To become a CAC you must work for a Certified Application Counseling Organization. • The representative for your facility is responsible for assigning all potential CACs their ID number. • Once all training is completed, the organization will view all certificates to assure that the candidate has completed all required courses. • The representative from the CAC organization will produce a certificate for the CAC which must be posted for all customers to see at all times.

5. Why become a CAC Organization? • Your facility becomes a trusted resource for patients and customers. • The CAC is also a resource within your own organization to help employees understand the ACA and options available to patients. • Nationally 75% of the newly eligible said they wanted in-person assistance to learn about and enroll coverage. (Enroll America Research 2012) • Recent polls by the Kaiser Family Foundation found that more than two-thirds (67 percent) of uninsured Americans age 65 and younger and 57 percent of the overall population say they do not understand how the Affordable Care Act will affect their lives. 42 percent of us are still unaware that health care reform has been the law of the land since 2010.

6. Responsibility of a CAC: • Educate patients or customers on the Health Insurance Marketplace. • Help customers gather information and apply for a qualified health plan on the Health Insurance Marketplace. • Help customers choose a health plan that fits their families needs. • CACs cannot recommend any specific health plan to a customer. • Help the customer gather and send any supporting documentation requested by the marketplace. • Help customers file appeals if they think they did not get accurate eligibility results from the Marketplace. • If needed, refer customers to other organizations such as Navigators or Agents and Brokers.

7. National Averages • More than 4,400 Assister Programs, employing more than 28,000 full-time-equivalent staff and volunteers, helped an estimated 10.6 million people during the first Open Enrollment period. (Kaiser Family Foundation, 2014) • Assistance resources were not evenly distributed across states.  In states with State-based Marketplaces (SBM) and Consumer Assistance Partnership Marketplaces (FPM), there were about twice as many Assisters available per 10,000 uninsured, compared to states with a Federally-facilitated Marketplace (FFM). (Kaiser Family Foundation, 2014) • Overwhelmingly, Assister Programs report people sought help because they simply do not understand the ACA or health insurance and lacked confidence to apply on their own. (Kaiser Family Foundation, 2014) • Ninety percent of Assister Programs have already been re-contacted by consumers with post-enrollment questions and problems. (Kaiser Family Foundation)

8. Next Year • Three-quarters of Assister Programs say it is very likely they will continue to provide Marketplace assistance next year. • Prior to the first Open Enrollment, 30% of Assister Programs had no prior experience helping consumers and just 16% had experience helping consumers enroll in private health plans.  Because so many Assister Programs expect to continue operating next year, the level of experience will likely increase going forward.  If Marketplaces continue to invest in resources to support Assister Programs, there could develop a profession of expert Assisters who understand consumer needs and how ACA rules and coverage options apply to them.

9. Healthy Michigan Plan: • AKA expanded Medicaid. • No asset test • People are approved based on family size and income only. • Provides dental and vision services along with all 10 essential health benefits as outlined in the ACA. • Members must be between the ages of 19-64 and be below 133% of the FPL. • The member cannot be on Medicare.

10. Northern Michigan Percentage of the eligible population signed up for HMP as of 09/15/14: NHP Service area: THP Service Area: Alpena-82% Crawford-91% Grand Traverse-65% Antrim-69% Kalkaska-82% Benzie-61% Charlevoix-68% Lake-95% Leelenau-45% Cheboygan-89% Manistee-84% Emmet-82% Mason-82% Montmorency-92% Mecosta-63% Alcona-78% Otsego-106% Missaukee-73% Iosco-84% Presque Isle-87% Newaygo-84% Ogemaw-93% Oceana-59% Oscoda-70% Wexford-98% Roscommon-100%