Navigators and Certified Application Counselors
- 2022 Assister Training Resources
- AHCCCS 2022 Eligibility Requirements
- AHCCCS Update for Assisters
- Ambertter from AZ Complete Health 2023
- Answer Key Tucson Scenario Workshop Cover AZ 2022
- AZ Department of Insurance Cover AZ 2023
- BCBS ACA Navigator Product Training – October 7, 2022
- Cigna – Cover AZ Assister Training – October 20, 2022
- FPL Guidelines – 2022
- HHS & CMS For Open Enrollment X
- Imperial – ACA Marketplace 2020 Arizona
- Oscar – Cover AZ Webinar Deck
- Scenarios Presentation Answers 2022
- UnitedHealth – Arizona Presentation
- 2021 Assister Training Resources
- 2021 FPL Chart
- AHCCCS Eligibility Requirements
- Ambetter from AZ Complete Health Training
- BCBSAZ Training
- Bright Training
- Case Scenarios – Southern Arizona
- Case Scenarios – Central Arizona
- Case Scenarios – Northern Arizona
- Department of Insurance Presentation
- El Rio 2021 Outreach Presentation
- HHS, CMS Presentation
- Medica Presentation
- North Country Healthcare Presentation
- Keogh Health Connection Outreach Presentation
- Outreach Strategy: AZ Alliance for Community Health Centers
- United Healthcare Training
- 2020 Assister Training Resources
- Virtual Group Picture
- Session 1: “Getting Ready for Open Enrollment, Updates, & Case Studies”
- Session 2: “Marketing and Outreach in a COVID-19 Environment”
- Recording
- Maps:
- Slide deck
- Handouts:
- Session 3: “Marketplace Insurance Companies”
- Recording
- Insurance Companies Presentations:
- 2019 Assister Training Resources
- Ambetter Presentation
- BCBS Presentation
- Bright Health Presentation
- CMS Presentation
- Master Cover AZ Presentation
- Marketplace Enrollment 2014-2019
- KidsCare Outreach Opportunities
- Uninsured Rate by Legislative District
- Uninsured Rate by County
- Flagstaff Group Photo
- Phoenix Group Photo
- Tucson Group Photo
- Yuma Group Photo
- 2018 Assister Training Resources
- AACHC Public Charge Update
- AACHC Public Charge Fact Sheet
- AHCCCS FPL Chart
- Ambetter Presentation
- Ambetter Welcome Packet
- Ambetter ID Card
- AZ Dept. of Insurance Presentation
- BCBS Presentation
- BCBS Suite E Rate Sheet
- BCBS 2019 Comparison Chart
- BCBS Cost Sharing Reductions Comparison Chart
- Bright Health Booklet Navigator
- Bright Health Presentation – Maricopa County
- Bright Health Presentation – Pima County
- Case Scenario Workshop
- Case Scenarios
- Cover AZ Master Slide Deck
- HHS Presentation
- New Coverage Options
- Oscar Presentation
- Photo – Flagstaff
- Photo – Phoenix
- Photo – Tucson
- Photo – Yuma
- FFM Assister Training 2016 (CMS)
- Designing Navigator Programs to Meet the Needs of Consumers: Duties and Competencies (PDF, Georgetown University Health Policy Institute)
- Help Wanted: Preparing Navigators and Other Assisters to Meet Consumer Needs (web page, Families USA)
- RWJF Navigator Resource Guide
- Families USA Assister Resource Center – Tools
- Becoming a Certified Application Counselor in Arizona
- Motivational Interviewing 101
- Motivational Interviewing – States of Change
- New Assister Resources
- Recertification for Navigators and CACs
- Strategies for Supporting Informed Consumer Decision Making
- Supporting Informed Decision Making – Progress Report
- Communicator’s Guide (CMS)
- Topics the Marketplace Call Center Will Handle
- Role of Assisters After Open Enrollment (CMS)
- SHIP Contacts for the state of Arizona
Brokers and Agents
Tax Credits
- ABCs of the Premium Tax Credit
- Deciphering the Health Law’s Subsidies for Premiums
- Help Consumers Learn about the New Health Premium Tax Credit
- The Health Assister’s Guide to the Tax Rules
- Calculate the Premium Tax Credit (Center on Budget and Policy Priorities, slide)
- Tax Credit Subsidy Chart 2015
- Save on Monthly Premiums (CMS)
- How to Save on Monthly Insurance Premiums (CMS)
- Determine Eligibility for Premium Tax Credits (CBPP)
- Presentation on Premium Tax Credits (CPBB)
- FAQ – Premium Tax Credits
- Understanding Premium Tax Credits and Cost Sharing Reductions (Georgetown)
- Reconciliation of Advanced Premium Tax Credits (In the Loop)
- FAQ – ACA & Premium Tax Credits
- Premium Tax Credits (IRS)
- Advanced Payments of Premium Tax Credits and Cost-Sharing Reductions (Manatt)
- Tax Filing for Married, Separated, and Abandoned Spouses
Applications, Application Assistance
- Key Dates for OE3
- Field Guide to Enrollment
- Helping Consumers Sign Up for Health Insurance (CMS)
- Value Judgment: Helping Health Care Consumers Use Quality and Cost Information (web page, California Health Care Foundation)
- Helping Consumers Choose Health Plans in Exchanges: Best Practice Recommendations
- Marketplace Checklist – Self-Purchased Coverage, Ineligible for Job-Based Coverage
- Marketplace Checklist – Job-Based Health Insurance
- Marketplace Checklist: Eligible But Not Enrolled in Job-Based Coverage
- Marketplace Checklist: Ineligible for Job-Based Coverage
- Marketplace Checklist: Small Business Owners
- Marketplace Determination Notice Example
- Health Insurance Marketplace 101 Refresher
- How to Help Without Crossing the Line
- Income Inconsistencies for Families with Dependents Receiving Social Security Benefits (CBPP)
- Insurance Cancellation Letters
- Submitting Supporting Documents to HIM
- Marketplace Step by Step Instructions (Cover Lemay)
- Applying in the Marketplace If You Can Get Job Coverage
- HIM Website Guide
The Unbanked and Payment Options
- Premium Payments and Grace Periods
- National Community Tax Coalition Prepaid Debit Card Comparison Tool
- FAQs on Unintended Consequences of the Federal Decision on Automatic Payments (Jackson Hewett Tax Service)
- Illinois Info on Options for Unbanked
Eligibility
- 2015 AHCCCS Eligibility Requirements
- Verification of Eligibility
- Eligibility Decision Tree
- FAQ – Remote Identity Proofing
- FAQ – Periodic Data Matching
- Talking Points for Responding to Data Matching Issues
- 2014 Poverty Level Chart
- Whose Eligibility is Based on MAGI?
- Summary of Medicaid Household Rules (Center on Budget and Policy Priorities, slide)
- How to Determine An Individual’s Medicaid Household (Center on Budget and Policy Priorities, slide)
- Calculating Modified Adjusted Gross Income (Center on Budget and Policy Priorities, slide)
- The New World of MAGI Income (corrected, updated 9-24)
- AHCCCS Information for Applicants Spanish
- AHCCCS Information English
- MAGI Summary (UC Berkeley)
- MAGI-In The Loop
- MAGI Household Income Rules
Health-E-Arizona Plus and the Marketplace
- Health E Arizona Plus Presentation (Powerpoint file)
- Medicaid Restoration, and New Technology for Public Assistance in Arizona
- Health-e-Arizona Plus Subscription Fees Beginning 10/1/13
- AHCCCS 10/09 update on Transition Plan and Health E Arizona Plus and the Marketplace
- Health-E-Arizona Documents Checklist English, Spanish
Medicaid and Chip Enrollment and Renewal
- CMS: In-Person Assistance in the Health Insurance Marketplace
- CMS Letter to Medicaid Directors r.e. Medicaid and CHIP Enrollment and Renewal in 2014 (May 2013)
Cost Sharing
- Patient Cost Sharing Under the Affordable Care Act and ACA Rules for Benefits and Cost Sharing
- What in the Word Happened with Out of Pocket Limits This Week?
Complaints and Appeals
- Marketplace Appeal Request Form English, Spanish
- Appeals Cheat Sheet
- Resources at the ADOI for Navigators and CACs
- Internal Claims and Appeals and External Review Process Overview
- Appeals Eligibility and Health Plan Decisions
- How to Appeal a Marketplace Decision (CMS)
- Authorized Representative Form for Appeals English, Spanish
- Guidance to AZ Department of Insurance
Renewal, Redeterminations
- CMS Guidance on Redeterminations for 2015
- Renewals Flow Chart
- What Can Marketplace Consumers Expect at Renewal? (Georgetown)
- Keep or Change Your Plan (CMS)
- CMS Renewal Notice
Plan Comparison and Selection
- Plan Selection (Families USA)
- Health Insurance Checklist
- Helping Consumers Pick a Plan That Will Meet Their Health Needs (Families USA webinar)
- Comparing Health Plans (CMS)
- Catastrophic Plans-In The Loop
- Plan Selection and Enrollment (CPBB)
- Marketplace Plan Comparison Worksheet (CBPP)
- QHP Individual Market Medical Plans Spreadsheet
- Geographic Regions in Arizona 11-19-14
Minimum Essential Coverage
Health Literacy
- Coverage to Care
- Health Insurance Coverage Terms (CMS)
- Choosing and Using A Health Plan: What You Need to Know
- How to Talk To Consumers About Health Insurance
- Health Insurance Terms-In The Loop
- A Consumer Guide to Understanding Health Plan Networks
- Consumer Reports FREE Health Literacy Resources
- Health Insurance Explained: The YouToons Have It Covered
Fees and Exemptions
- Fees and Exemptions (CMS)
- Enrolling with Limited Circumstance or Qualifying Even SEP (CMS)
- SEPs and Dates of QHP Coverage Fact Sheet (CMS)
- Exemptions and Special Enrollment Periods (CPBB)
- Exemptions Chart (FamiliesUSA)
- Exemptions, Standard Deduction, and Filing Info (IRS)
- Life Events that Create a Special Enrollment Period
- Triggers and Timing Chart
- Overview in Changes in Circumstances Functionality (CMS)
- Reporting Changes in Circumstance after Open Enrollment (CMS)
- SEPs for Complex Cases
- Helping Consumers with Complex Cases during SEPs
- How Big is the ACA Tax Penalty? A TPC Calculator (Urban Institute and Brookings Institution)
- Hardship Exemption Form
- Other Exemption Forms
- Objection by Recognized Religious Sect Exemption Form and Instructions
- IRS Information on Calculating Penalty
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