…and the national experts who provide them with technical assistance deal with more complex cases that challenge us as well. That said, structuring the call center with units dedicated to serving specific types of consumers would help build the expertise needed to deal with complicated situations. Additionally, involving stakeholders in reviewing call center scripts would go a long way to…
…Foundation, we at Georgetown’s Center on Health Insurance Reforms and Center for Children and Families have had the privilege of providing technical assistance to Navigator grantees in a handful of states. We asked for – and received – some of their thorniest and most complicated questions on the wide range of issues facing consumers as they apply for and enroll…
By Tricia Brooks, Georgetown University Center for Children and Families I recently drafted a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. Today, we’re going to drill down on how Medicaid and CHIP eligibility is based on current monthly income,…
Although the media storm over health plan cancellations has died down, there continue to be reports that a number of insurers have decided to discontinue noncompliant health plans, even though they are permitted to maintain them under state and federal law. In a new blog post for the Commonwealth Fund, Kevin Lucia, Sabrina Corlette, and Ashley Williams examine the effect…
…product meets the definition of “excepted benefits” is more complicated. “Excepted benefits” are divided into four categories: (i) benefits that are not health coverage (even if they incidentally cover medical care), (ii) limited-scope benefits, (iii) non-coordinated benefits, and (iv) supplemental benefits. Policies that are non-health types of coverage are narrow and specifically defined in the statute and regulation (e.g., workers’…
…call center has been horrendous,” summarizes a common view. In addition to long wait times, brokers were frustrated by the lack of knowledge and expertise of call center workers. Compensation challenges. Brokers in some states reported difficulties ensuring that the work they did for a client would be correctly attributed back to them (a necessary prerequisite to payment). Others complained…
…example demonstrating how the tax credits are computed. The new Chapter 11 provides basic information about 1095-A forms, incorrect forms, and information about routing callers that require additional assistance. The ACA Consumer Services Toolkit is designed to provide a quick reference for consumer service representatives to use when working with consumers seeking information about their coverage or help in dealing…
…reduction in hours for employers to avoid the employer penalty with a 40-hour definition. A Commonwealth Fund report estimates that twice as many employees would be at a high risk for reduced hours, even when excluding companies already providing health insurance. The CBO estimates that a 40-hour definition could affect as many as 1 million workers who would see their…
The cost of a routine surgery, such as hip or knee replacement, can vary widely between providers with no seeming correlation between cost and quality – a phenomenon many health policy experts have been describing for the past several years. However, last week, the Blue Cross Blue Shield Association published a report that shed some light on just how much…
…leaders make the case for proceeding with ACA-compliant wellness programs without interference from the EEOC. But the ACA is clear that the HIPAA rules that govern workplace wellness programs aren’t the only consideration. The preamble to the workplace wellness rule states, “compliance with the HIPAA nondiscrimination and wellness provisions is not determinative of compliance with any other applicable Federal or…
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