The point of navigators and certified application counselors for the new health insurance marketplace that will open Oct. 1 is generally to provide in-person assistance.
But as for themselves, the navigators and CACs are being trained online. According to the Centers for Medicare & Medicaid Services, the required course is 20 hours for navigators and five hours for CACs, with passage of an exam required for both.
However, CMS noted, the training is not intended to be a one-time-only process. Going forward, there are supposed to be regular refresher opportunities to share updates, receive information and address issues.
"As open enrollment proceeds, and we learn more about consumers' needs, we will respond by providing additional guidance," CMS said.
Family First Health, a federally qualified health center serving York and Adams counties, will have both types of assisters. Jenni Black, FFH's chief administrative officer, said there will be three navigators and five to nine CACs.
"Both can assist patients in enrolling," Black said. The difference between them — beyond the training times — is essentially that navigators will be required to participate in outreach, while CACs will not, she said.
FFH isn't new to the process of helping people enroll in medical coverage. With more than 20 percent of its patient population uninsured, it has had an eligibility department that worked to get people into Medicaid and Children's Health Insurance Program. FFH is renaming the department Health Insurance Navigation and Enrollment.
Although staff members are already familiar with eligibility systems and insurance terminology, Black said they were expecting the federal curriculum to be helpful.
"We printed out just the five-hour training course manual," Black said. "It's about 2 inches thick. It's really important information; it covers things like the difference between a PPO, HMO, fee for service."
But, Black said, for Pennsylvania the training doesn't include something that the FFH staff thinks would be most helpful: a matrix of the plans that fall into each of the metal tiers that will be used the classify the systems, what those plans include and what the relevant prices are. That's because Pennsylvania's plan will be federally facilitated, and the feds are not releasing rates prior to the opening of the marketplaces.
So, Black said, they will be getting up to speed on that information as fast as possible once it is available.
The Pennsylvania Association of Community Health Centers also will be heavily involved with marketplace outreach and enrollment efforts.
"We're serving in essentially a lead navigator role," said Cheri Rinehart, PACHC president and CEO. To help coordinate the activity, it is developing an online database to track information such as how people found out about the marketplace, how they were referred to assisters and what barriers they encountered to completing enrollment.
Mike Williams, statewide director of outreach and enrollment for PACHC, noted there also will be monthly networking calls to help answer questions for the assisters, implement the best strategies and help everyone learn from each other.
Asked if there's enough time before the marketplaces open to do all the training PACHC would like to, Williams said no. But, he added, it's important to recognize that Oct. 1 is not a deadline; the marketplaces open that day, but coverage doesn't start until Jan. 1, 2014, and the enrollment period will last for six full months, through the end of March 2014.
What will help the campaign most, Rinehart said, is getting people to sign up for marketplace email updates at healthcare.gov.
"There are a lot of tools on there," she said, and the more people avail themselves of the online assistance, the better.