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Application Assistance

  • Application Assistance 101

    December 2013

    You may be a navigator, a certified application counselor (CAC), an in-person assister (IPA), or a staff member at a community health center (CHC). But regardless of your title or where you work, if you help consumers apply for health insurance (including Medicaid and the Children’s Health Insurance Program—CHIP) through the marketplace, this fact sheet includes questions to consider and best practices you may want to implement.

  • Certified Application Counselor Program: Early Lessons

    June 2014

    This brief examines examines the different funding, training, and program design decisions Certified Application Counselor (CAC) organizations made during the first open enrollment period, and offers recommendations for strengthening these programs going forward.

  • Coordinating Assistance Efforts: Lessons from Wisconsin

    October 2013

    Consumer outreach and enrollment assistance is critical to maximizing the number of people who enroll in health coverage. This brief explores a promising strategy from Wisconsin, where stakeholders have created regional enrollment assistance networks throughout the state despite limited state and federal resources.

  • Facts about the Certified Application Counselor Program

    July 2014

    Certified Application Counselors (CACs) provide free, unbiased assistance to consumers applying for and enrolling in health coverage. This fact sheet explains the significance of CAC programs, the process for becoming a CAC organization, and the duties of CACs.

  • In-Person Assistance Maximizes Enrollment Success

    March 2014

    Consumers now have the opportunity to learn about and enroll in affordable health coverage in a variety of ways, including through in-person enrollment assistance from a trained and certified person in their community. In-person assistance has played a crucial role in maximizing enrollment during this first open enrollment period.

  • Making the Connection 2.0: Insights Into In-Person Assistance From the Get Covered Connector

    April 2016

    Building on a successful inaugural year of the Get Covered Connector, Enroll America worked to refine the tool’s functionality for assisters, added new training focusing on ways to leverage the tool for maximum impact, and expanded its reach during the third open enrollment period. This issue brief describes the changes and growth of the Connector in OE3, as well as insights for the enrollment community on consumers’ behaviors and needs regarding in-person assistance. 

  • Making the Connection: How Centralized Scheduling Benefits Consumers, Assisters, and the Enrollment Community

    April 2015

    This issue brief explores how assistance-scheduling tools — including the Get Covered Connector — can help make in-person enrollment assistance more accessible. Drawing on new data from the Connector, the issue brief includes key findings on consumer behavior and preferences for getting in-person enrollment help.

  • Navigating the New Health Insurance Marketplaces: In-Person Assistance Options for Consumers

    September 2013

    Consumers will have many different ways to get personal help with enrollment, and our fact sheet breaks down four types of trained and certified helpers they can find in their community.

  • Navigator and In-Person Assistance Programs

    Updated January 2013

    This fact sheet summarizes the basics of the navigator and in-person assistance programs.

  • The Certified Application Counselor (CAC) Program: Facts about the CAC Designation for Organizations

    September 2013

    Find out how you or your organization can get trained and certified to help walk consumers through their new health insurance options and the financial help they may be eligible to receive.

  • The Importance of In-Person Assistance

    August 2012

    This issue brief examines the importance of in-person assistance and identifies a variety of ways stakeholders can help their state develop a robust outreach and application assistance network.

Enrollment and Renewal

  • Amplifying the Connections Between Health Coverage Enrollment and Tax Filing

    September 2015

    This issue brief shares lessons learned on how consumers navigated the new connections between health coverage and the tax filing process in 2015, and offers recommendations for policymakers and other enrollment stakeholders about how to improve the consumer experience.

  • An Enrollment Checklist for 2012

    March 2012

    This issue brief describes seven essential things that stakeholders can do to keep enrollment efforts on track in 2012: take advantage of opportunities for federal funding, develop an effective outreach plan, automate enrollment, minimize documentation requirements, promote data-driven, integrated eligibility systems, ensure a comprehensive approach to consumer assistance, and create materials that are easy to read and understand. Also see the companion two-page fact sheet.

  • Cost Information More Important Than Fine Language among Calculator Users

    March 2015

    This memo outlines findings from a digital test that aimed to determine if consumers would be more likely to start the enrollment process when exposed to information about the fine for not having coverage and, if so, what fine language was most effective for motivating consumers to enroll.

  • Enroll America’s Grassroots Campaign and Early Lessons Learned, November 2013–February 2014

    April 2014

    This report describes the innovative campaign tactics Enroll America uses to connect consumers to the new health coverage options. It also shares some of the data collected between November 2013 and February 2014 on consumers’ experiences enrolling in coverage. These data provide insight into who is attempting to enroll, who has enrolled, what kind of challenges consumers have encountered, and what methods of enrollment they prefer.

  • Exemptions for Consumers without Health Coverage in 2015

    January 2015

    This fact sheet lays out next steps for consumers who do not enroll in health coverage for 2015 and may be exempt from the fine in 2016.

  • Exploring Variation in States’ Changing Uninsured Rates From 2014 to 2015

    January 2016

    According to Enroll America’s predictive data model, the uninsured rate dropped in every state and the District of Columbia from 2013 to 2015 — the first years of the Affordable Care Act’s expansion of health coverage. The data from 2014 to 2015 tell a more nuanced, state-by-state story, and this paper explores potential factors for state variation in changing uninsured rates.

  • Fast-Track Medicaid Enrollment Saves States Money

    June 2014

    Fast-track enrollment strategies do more than help people sign up for Medicaid — they save states money. These strategies speed up the eligibility process by allowing states to use information they already have on file from other public benefit programs. By vastly reducing the time eligibility workers spend processing Medicaid applications, fast-track strategies can reduce administrative expenses. This brief examines the costs and savings of two states — West Virginia and Illinois — implementing fast-track enrollment in Medicaid.

  • Five Recommendations to Make Renewal a Success

    June 2014

    Enroll America offers the following recommendations for the Department of Health and Human Services (HHS) and state policymakers to consider as they institute marketplace and new Medicaid renewal policies for the first time this fall.

  • Helping Consumers Keep Affordable Health Coverage

    February 2014

    Providing outreach and enrollment assistance is critical to maximizing the number of people who enroll in health coverage. However, it is just as important to educate consumers about their responsibilities once they are enrolled to ensure that they keep their coverage. This issue brief describes how to help consumers retain their coverage.

  • How States Can Accelerate Their Enrollment Efforts

    June 2013

    This fact sheet summarizes opportunities for states to simplify and streamline enrollment.

  • Questions and Answers from the September 28 Webinar: “Choices for States in the Newest Federal Eligibility and Enrollment Regulations“

    October 2011

    This document addresses the most frequently asked questions during Enroll America’s first webinar.

  • State Estimates of the Number of Uninsured Adults Eligible for a Special Enrollment Period in 2014

    August 2014

    This publication provides national and state-level estimates of the percent of currently uninsured individuals who are likely to have experienced at least one of these qualifying events during the seven months between open enrollment periods and are therefore eligible for a Special Enrollment Period.

  • Telephonic Signatures: An Essential Tool for Enrollment

    February 2013

    Benefits Data Trust partnered with Enroll America to develop this short policy brief to highlight the importance of telephonic signatures, or “spoken signatures,” as a crucial technology solution to ensure a smooth application and enrollment process for those applying for health coverage over the phone.

  • Ten Ways to Make Health Coverage Enrollment and Renewal Easy

    August 2011

    Enrolling tens of millions more Americans in health coverage beginning in 2014 will require a significant departure from the traditional thinking about enrollment processes. This piece outlines key elements of this new vision for enrollment that will position states to maximize the number of people who are quickly and easily enrolled in coverage.

  • The Ideal Application Process for Health Coverage

    February 2012

    The Affordable Care Act requires states to use a single, streamlined application for all health coverage programs beginning in 2013. This issue brief explains the key steps in a streamlined application process and why they promote robust enrollment.

  • Third-Party Payment: An Innovative Financial Help Model

    September 2014

    Third-party payment programs can make health coverage even more affordable for marketplace enrollees. This issue brief examines the implementation of third-party payment programs in Wisconsin and Oregon, raises questions stakeholders should consider when deciding whether to pursue similar programs in their region or community, and offers a detailed history of federal guidance on the topic.

  • Updated: Exemptions for Consumers without Health Coverage in 2014

    January 2015

    How will consumers who did not enroll in coverage for 2014 be affected in 2015? The table in this fact sheet outlines who may be subject to the fine, who may qualify for an exemption, and which steps to take to secure an exemption.

  • Using Electronic Data to Make Enrollment Easier: A Closer Look at Utah’s eFind System

    August 2011

    Building systems that make optimal use of information technology to simplify enrollment is paramount to getting millions of Americans enrolled in coverage. Utah’s eFind system provides one example of how to tap into existing databases to streamline the eligibility process. This piece provides an in-depth look at eFind and how it gathers readily-available electronic data from federal, state, and local databases to better determine applicant eligibility for a variety of public assistance programs.

Health Literacy/Health Insurance Literacy

  • A Framework on Health Insurance Literacy for the Outreach and Enrollment Community

    May 2015

    This issue brief describes the connection between health insurance literacy and retaining coverage, includes early findings on how to increase consumers’ health insurance literacy, and features key considerations for stakeholders working to improve retention and consumer comprehension.

  • An Introduction to Health Literacy and Enrollment

    December 2011

    This piece is the first in a series of issue briefs authored for Enroll America by experts at the MAXIMUS Center for Health Literacy on best practices for writing and designing materials–like websites, applications, instructions, and marketing materials–that are clear, easy to read and understand, and that make it easier for people to enroll in health coverage. The piece provides an introduction to why health literacy is important, particularly when it comes to communicating effectively with the uninsured.

  • Communicating with Plain Language

    February 2012

    This piece is the second in our health literacy series authored by our partners at the MAXIMUS Center for Health Literacy. It offers ten easy tips for writing clear, concise, user-friendly materials.

  • Design that Enhances Readability

    April 2012

    This piece is the third in our health literacy series authored by our partners at the MAXIMUS Center for Health Literacy. It focuses on how to use white space, alignment, and font choices to make enrollment materials easier to read and understand.

  • Translations that Hit the Mark

    October 2012

    Part of our health literacy series, this brief focuses on when and how to translate written materials into languages other than English, as well as how to ensure that you end up with high-quality translations. It also provides tips on managing the translation process.


  • Connecting with Consumers through Phone-a-Thons

    March 2014

    Inviting consumers to pick up the phone and dial in can be an effective way to turn outreach on its head and bring consumers to you. This fact sheet is designed to help you understand how to plan a phone-a-thon to help connect consumers to health insurance.

  • Engaging Ethnic Media to Help Spread Your Message

    March 2014

    More than half of the uninsured are people of color, which makes working with ethnic media outlets a key strategy for reaching newly eligible consumers. This fact sheet walks you through how to create constructive partnerships with ethnic media outlets.

  • How to Create an Outreach Work Plan

    December 2013

    It’s a good idea to establish an outreach work plan to help you structure and evaluate your outreach efforts. Feel free to use this detailed guide to get started. We’ve also provided two sample work plans to use as templates.

  • Outreach Planning 101

    July 2013

    This outreach guide provides ideas for how to get started on an outreach plan, tips to keep in mind as you plot out your strategies and materials, ways to inform people about the new health coverage options, and an outreach worksheet to track your success.

  • Outreach Planning 2.0

    December 2013

    This guide has three sections to assist you in the process of starting, adapting, and improving your efforts:

    1. Setting Up Your Infrastructure and Processes
    2. Preparing to Direct Consumers to the Right “Door”
    3. Measuring Your Success


  • Health Centers and Enrollment: A Two-Part Series

    September 2012

    Starting in 2014, millions of Americans will become eligible for health coverage offered through health insurance exchanges and through Medicaid, which will dramatically alter the landscape for health centers. Health centers have long played a crucial role in providing affordable, high-quality, community-based care to vulnerable populations. Based on interviews with staff from health centers and primary care associations in four states (Arizona, Michigan, Texas, and Washington), these pieces highlight the crucial role health centers play in outreach and enrollment and the best practices they can implement as health coverage opportunities are expanded.

  • Presumptive Eligibility

    January 2013

    This fact sheet describes the options for states and hospitals to make presumptive eligibility determinations starting in 2014.

  • Presumptive Eligibility Toolkit

    Last Updated April 2015

    We’ve put together this toolkit to help hospital administrators understand and make the most of the unique opportunity to enroll patients and their families who are likely to be eligible in Medicaid for a temporary “presumptive eligibility” period using a vastly simplified application.

  • Promising State Approaches for Using Hospital Presumptive Eligibility

    February 2014

    Although it is too early to connect specific hospital presumptive eligibility (HPE) policies with increased enrollment, many promising practices have begun to emerge. This fact sheet provides suggestions for HPE policies that hospitals can work with their state to implement. Examples include developing high-quality training materials, establishing realistic performance standards, and creating consumer-friendly policies.

  • Tips for Talking with Your Patients About Their Health Coverage Options

    Updated February 2015

    Providers are trusted sources of information for their patients, and our fact sheet arms providers with simple messages that will greatly increase their uninsured patients’ interest in enrolling, identifies clear next steps providers can empower patients to take, and outlines easy ways to spread the word to patients that new health coverage options are available.

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