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Certified Enrollment Counselor Role Participant Guide Version 2.0

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Certified Enrollment Counselor Role Participant Guide

Version 2.0

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

Page i

TABLE OF CONTENTS

1. STAGE 1: CERTIFIED ENROLLMENT COUNSELOR ROLE ...........................................................1

1.1. LEARNING OBJECTIVES .....................................................................................................1

2. LESSON 1: INTRODUCTION TO THE CERTIFIED ENROLLMENT COUNSELOR ROLE ......................2

2.1. LEARNING OBJECTIVES......................................................................................................2

2.1.1. WHAT IS A CERTIFIED ENROLLMENT COUNSELOR? ........................................................2

3. LESSON 2: WHAT ARE THE CERTIFIED ENROLLMENT COUNSELOR ROLES AND RESPONSIBILITIES? ...............................................................................................................3

3.1. LEARNING OBJECTIVES .....................................................................................................3

3.1.1. WHAT IS THE ROLE OF THE CEC? ...............................................................................3

3.1.2. HOW TO HANDLE MEDIA QUESTIONS ............................................................................4

4. LESSON 3: WHAT MAKES A CERTIFIED ENROLLMENT COUNSELOR SUCCESSFUL? ...................4

4.1. LEARNING OBJECTIVES .....................................................................................................4

4.1.1. WHAT ARE THE STEPS TO BE A SUCCESSFUL CEC? .....................................................5

4.1.2. STEP 1: FOLLOW-UP AND FOLLOW-THROUGH ON CONSUMER LEADS .............................5

4.1.3. STEP 2: IDENTIFYING UNINSURED CONSUMERS INTERESTED IN COVERED CALIFORNIA ...5

4.1.4. STEP 3: SET AN APPOINTMENT TIME TO PROVIDE ENROLLMENT ASSISTANCE ..................5

4.1.5. STEP 4: WALK THROUGH THE ENROLLMENT PROCESS WITH THE CONSUMER ..................6

4.1.6. STEP 5: APPROACH THE PROCESS WITH SENSITIVITY AND CONFIDENTIALITY ..................6

4.1.7. STEP 6: PROVIDE INFORMATION AND ASSISTANCE IN WAYS THAT ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE AND MEET THE STANDARDS OF THE ADA .......................7

4.1.8. STEP 7: COMPLY WITH ALL FEDERAL AND STATE REGULATIONS AND PROGRAM REQUIREMENTS .........................................................................................................8

4.1.9. STEP 8: FOLLOW-UP WITH ANNUAL RENEWALS ............................................................8

5. LESSON 4: HOW WILL COVERED CALIFORNIA MEASURE ENROLLMENT EFFECTIVENESS? ...........8

5.1. LEARNING OBJECTIVES .....................................................................................................8

5.1.1. PERFORMANCE, REPORTING AND MONITORING ...........................................................9

6. STAGE II: CERTIFIED ENROLLMENT COUNSELOR ROLE .........................................................10

6.1. LEARNING OBJECTIVES ...................................................................................................10

7. LESSON 5: WHAT ARE THE NEXT STEPS AFTER CECS COMPLETE TRAINING? ..........................10

7.1.1. NEXT STEPS ............................................................................................................10

8. LESSON 6: WHAT SUPPORT EXISTS FOR CERTIFIED ENROLLMENT COUNSELORS? ...................12

8.1. LEARNING OBJECTIVES ...................................................................................................12

8.1.1. WHAT SUPPORT EXISTS FOR CERTIFIED ENROLLMENT COUNSELORS? ........................13

8.1.2. ACTIVITY 1...............................................................................................................15

8.1.3. ACTIVITY 2...............................................................................................................16

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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9. ACTIVITY ANSWERS .............................................................................................................17

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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1. STAGE 1: CERTIFIED ENROLLMENT COUNSELOR ROLE In this course, you will learn about the Certified Enrollment Counselor role, responsibilities and how performance is monitored and evaluated. You will also learn about Covered California’s online system as well as the resources available to support day-to-day activities.

1.1. LEARNING OBJECTIVES At the end of this course you will be able to:

Describe the Certified Enrollment Counselor roles and responsibilities

Understand the types of performance monitoring for the role

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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2. LESSON 1: INTRODUCTION TO THE CERTIFIED ENROLLMENT COUNSELOR ROLE

In this lesson, you will learn about the Certified Enrollment Counselor role and how it functions as an important part of Covered California.

2.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Understand the Certified Enrollment Counselor role

Define a Certified Enrollment Counselor

Define a Certified Enrollment Entity

2.1.1. WHAT IS A CERTIFIED ENROLLMENT COUNSELOR? The Certified Enrollment Counselor functions within Certified Enrollment Entities which are made up of trusted and known organizations that serve as critical resources for consumers. The Certified Enrollment Counselor program is designed to provide one-on-one, in-person assistance to educate consumers on health care options and guide the enrollment process. During the early years of Covered California, about 50 percent of targeted consumers (over 2.5 million) are expected to need personal assistance. The chart below depicts an overview of the consumer process in Covered California:

Certified Enrollment Counselors Provide In-Person Assistance at this stage

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Within the Certified Enrollment Counselor role there are two primary facets: Certified Enrollment Entity (CEE) The CEE is the organization that provides the resources for consumers. The CEE is responsible for promoting Covered California as a trusted resource for health care coverage by establishing an internal system of quality and compliance while adhering to Covered California’s monitoring and evaluation requirements. CEE’s have direct access to Covered California’s primary populations.

Certified Enrollment Counselor (CEC) The CEC is an individual that works for or volunteers with a CEE. This is the individual that is responsible for providing one-on-one, in-person assistance to educate consumers on health care options and guide the enrollment process.

3. LESSON 2: WHAT ARE THE CERTIFIED ENROLLMENT COUNSELOR ROLES AND RESPONSIBILITIES?

In this lesson you will learn the functions of a CEC, and the essential roles and responsibilities involved with this position.

3.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Define the roles and responsibilities of a CEC

Identify the Do’s and Don’ts of a CEC

Learn how to handle media questions

3.1.1. WHAT IS THE ROLE OF THE CEC? CECs will provide one-on-one assistance to consumers, helping them understand what Covered California is, what the consumer’s health insurance options are and how to enroll. The role of the CEC includes:

Maintaining expertise in eligibility, enrollment and program requirements

Educating consumers about health insurance in a fair and impartial manner

Providing in-person assistance to help individuals enroll in coverage (not over the phone)

Providing information in a culturally and linguistically appropriate manner

Assisting consumers in completing eligibility requirements for all coverage offered by Covered California and all other insurance affordability programs

Refer consumers with a grievance, complaint, or question about how a benefit decision was made to the applicable state agency

Wear the badge issued by Covered California at all times when providing consumer assistance

Only used approved program collateral materials with Covered California’s branding

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Assist consumers in post-enrollment activities, dis-enrollment, re-determination and general questions

CECs will help facilitate enrollment for consumers as well as explain all of Covered California services, including options for: individuals, families, small businesses, premium assistance and Medi-Cal. It is also important for CECs to support retention efforts, including coverage renewals, eligibility re-determination, re-verification of premium assistance/cost-sharing reductions and Medi-Cal re-determination.

Certified Enrollment Counselors must NOT:

Have a conflict of interest as defined in the CEC Agreement.

Mail the paper application for the consumer.

Coach or recommend one plan or provider over another.

Accept any premium payments from the consumer.

Input any premium payment information on behalf of the consumer.

Pay any part of the premium or any other type of consideration to or on behalf of the consumer.

Create multiple applications from the same household solely for the basis of increased compensation.

Invite, influence, or arrange for an individual whose existing coverage through an eligible employer-sponsored plan is affordable and provides minimum value.

Coach the consumer to provide inaccurate information on the application regarding income, residency, immigration status and other eligibility rules.

3.1.2. HOW TO HANDLE MEDIA QUESTIONS The media may approach you for information about Covered California. In your role as a Certified Enrollment Counselor you should not speak with the media about Covered California. Should any news agencies, reporters or journalists contact you, inform them that you do not engage the media and refer them to Covered California’s media line.

Covered California’s Media Line 916.205.8403

4. LESSON 3: WHAT MAKES A CERTIFIED ENROLLMENT COUNSELOR SUCCESSFUL?

In this lesson you will learn about the eight steps needed to achieve success in the CEC role.

4.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Identify the process in which to engage consumers in enrollment assistance

Provide information in an appropriate, sensitive and confidential manner

Understand program regulations and expectations for your role

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4.1.1. WHAT ARE THE STEPS TO BE A SUCCESSFUL CEC? There are eight steps that are critical to be a successful CEC. The chart below depicts each step:

Eight Steps to be a successful CEC

Step 1 Follow-up and follow-through on consumer leads

Step 2 Identify the uninsured and potential consumers interested in Covered California.

Step 3 Set a time for an appointment to provide enrollment assistance.

Step 4 Walk through the enrollment process with the consumer.

Step 5 Approach the process with sensitivity and confidentiality.

Step 6 Provide information and assistance in culturally and linguistically appropriate methods as required and meet the standards of the Americans with Disabilities Act (ADA)

Step 7 Comply with all Federal and State Regulations and with program requirements.

Step 8 Follow-up with annual renewals.

4.1.2. STEP 1: FOLLOW-UP AND FOLLOW-THROUGH ON CONSUMER LEADS Covered California will have a lead distribution system in place to disseminate leads to CECs for follow-up. It will be the CEC’s responsibilities to follow-through with all leads assigned by Covered California.

CECs will be required to monitor the status of any assigned leads and make sure that contact attempts to assist potential consumers are made.

4.1.3. STEP 2: IDENTIFYING UNINSURED CONSUMERS INTERESTED IN COVERED CALIFORNIA

Most CECs will become aware of uninsured consumers through their CEE’s network and activities. The CEE will help identify primary populations and channel those leads to the CECs.

CECs will need to determine the level of interest of uninsured consumers and answer general questions about Covered California in order to schedule an appointment.

4.1.4. STEP 3: SET AN APPOINTMENT TIME TO PROVIDE ENROLLMENT ASSISTANCE To best serve the consumer and facilitate a successful enrollment, the CEC should establish a timeframe for an appointment that will allow for up to 90 minutes. Providing an adequate window of time allows for all questions and concerns to be addressed without the consumer feeling rushed or pressured.

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At the time the appointment is scheduled, the CEC should end the communication by verifying these details:

Appointment date and time is satisfactory for the consumer The consumer knows how to find the location of the appointment Identify the consumers household income Remind the customer to have photo ID and Social Security Number ready at the

appointment All enrollment appointments should occur in a location that provides privacy and security to discuss the sensitive information contained in the application and allows access to a secure computer to access www.coveredca.com.

4.1.5. STEP 4: WALK THROUGH THE ENROLLMENT PROCESS WITH THE CONSUMER Upon arrival the CEC should greet the consumer in a friendly manner, be polite and courteous to establish a rapport. Be sure to explain to the consumer that the appointment could take as long as 90 minutes.

Approach the process with the “no wrong door” approach and ensure that all consumers receive assistance regardless of whether they:

Qualify for Medi-Cal or Covered California Health Plans

Have special language or cultural needs

Have disabilities or special circumstances

Walk through the online application and assist the consumer with completing all required information accurately to determine program eligibility and eligibility for financial assistance.

Assist the consumer to select the health plan that best meets their needs without guiding the consumer’s choices.

If the application cannot be completed during the appointment, a follow-up appointment is required to complete the application as soon as possible.

4.1.6. STEP 5: APPROACH THE PROCESS WITH SENSITIVITY AND CONFIDENTIALITY Information provided during the application process contains sensitive financial and health information. The Privacy and Security course discusses the definition of personally identifiable information (PII), federal tax information (FTI) and protected health information (PHI), the Health Insurance Portability and Accountability Act (HIPAA) and when this confidential information can be used and disclosed. The course also discusses ways to keep information secure, how to report privacy and security violations and the rights individuals have regarding their personal information. It is crucial for CECs to follow these rules and regulations regarding sensitive information in the course of their duties. It is also important to

Tip for Success

Call your consumer the day before your scheduled appointment to confirm their availability and remind them what to be prepared to provide. If the appointment is on a Monday, call the Friday prior.

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understand the regulations and penalties involved for individuals who do not handle confidential data in an appropriate manner.

CECs should always be looking out for information that is considered PII. PII is any information that identifies or describes an individual. Some examples of information that can be PII include:

Full Name

Birthplace

Email Address

Vehicle registration plate number

Credit card numbers

Country, state, zip code or city of residence

Name of school attended or workplace

Social Security Number

Biometric records

National Identification number

Driver’s license number

Age

Grades, salary or job position

Date of birth

Mother’s maiden name

To make the consumer feel comfortable, the CEC should:

Make sure that enrollment assistance is provided in locations that are private

Avoid asking personal questions not required as part of the enrollment process

Not retain any information used by the consumer as part of the enrollment process

Not mail in a paper application

Not collect any premium payments

4.1.7. STEP 6: PROVIDE INFORMATION AND ASSISTANCE IN WAYS THAT ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE AND MEET THE STANDARDS OF THE ADA

When engaging customers it is very important to do so in ways that are culturally and linguistically appropriate and meet the standards of the ADA.

CECs should develop and maintain general knowledge about the racial, ethnic and cultural groups of consumers including cultural health beliefs and practices, preferred languages, and health literacy.

Covered California requires that CECs provide services in-language including interpretation, at no cost to the consumer when necessary or requested to ensure effective communication. One method to easily achieve this is determining if the consumer has a family member that can be used to translate. Use of a consumer’s family or friends can satisfy the requirement if it is requested by the consumer as their preferred alternative. If a family member does not meet the consumer’s needs, the CEC should arrange for a third party language line through the Covered California Service Center at 888.975.1142.

To the extent possible, provide access to the location of the appointment that allows people with disabilities to come and go as easily as everyone else. Also, ensure communication with people with disabilities is effective, including providing materials suitable for those with hearing or visual impairment.

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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What is retention? Retention is the act of retaining or supporting a continued use or practice in Covered California enrollment and other qualified health plan services. Also included are follow-ups with annual renewals in Qualified Health Plans and re-determination for Medi-Cal

4.1.8. STEP 7: COMPLY WITH ALL FEDERAL AND STATE REGULATIONS AND PROGRAM REQUIREMENTS

There are many requirements, regulations and rules critical to your role in Covered California. The Compliance Standards course as well as the Privacy and Security course discuss the requirements and state and federal regulations in greater detail.

CECs must also abide by all requirements as outlined in the Certified Enrollment Counselor’s Agreement. These include:

All requirements related to privacy and security.

Not collecting payment (direct or indirect) for enrollment assistance services.

Not collecting premium payments for health insurance

Other important requirements include wearing the Covered California identification badge at all times while engaging customers.

The program at times will require CECs to satisfy training courses including updates, annual retraining and recertification.

CECs are also required to report any suspicious activity surrounding Covered California operations immediately to a Supervisor and/or Covered California as appropriate.

4.1.9. STEP 8: FOLLOW-UP WITH ANNUAL RENEWALS The role of the CEC is not finished after a consumer enrolls in Covered California. CECs will answer questions from consumers or refer consumers needing assistance to appropriate resources on an ongoing basis.

To the extent possible, CECs will follow-up with consumers annually for renewal of coverage in order to promote retention in a Covered California health plan. Promoting retention is a valuable role of the CEC to help keep the consumer engaged in Covered California.

5. LESSON 4: HOW WILL COVERED CALIFORNIA MEASURE ENROLLMENT EFFECTIVENESS?

In order to maintain quality, the CEC activities are closely tracked and monitored by the affiliated CEE and Covered California.

5.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Define Covered California’s performance requirements

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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Identify how CECs will be evaluated and monitored

5.1.1. PERFORMANCE, REPORTING AND MONITORING It is critical that each consumer’s interactions with a CEC are a positive experience. To maintain a high level of quality and consumer satisfaction, CECs are closely monitored and evaluated by the affiliated CEE and Covered California.

At a minimum, CECs are expected to:

Maintain accuracy in application submissions

Renew CEC certification each year, completing all training and other requirements for recertification

Represent the best interests of consumers

Act in an ethical manner and avoid all conflicts of interest

CEEs are responsible for promoting Covered California as a trusted resource for affordable health care coverage by:

Establishing an internal system for monitoring program quality and compliance; and

Adhering to Covered California’s monitoring and evaluation requirements.

CEE monitoring includes, at a minimum:

A mechanism(s) through which to evaluate the performance of CECs, including:

o verifying that activities are delivered as planned;

o evaluating the accuracy of education messages and information;

o reviewing quality of enrollment applications submitted; and

o Assessing overall compliance with program standards and guidelines.

Identification and reporting of instances of non-compliance of Privacy and Security regulations to Covered California within 30 days and specifying a plan(s) for corrective action;

Identification and reporting to Covered California within 30 days any and all concerns related to conflicts of interest, fraud, or violations of program standards;

Should any affiliated CEC or CEE be deemed no longer eligible to represent the program the CEC and/or CEE will be de-certified/de-registered by Covered California.

Covered California will also be monitoring the performance of CECs. These CEC performance evaluation activities include:

Consumer feedback

Field monitoring

Reviewing key performance indicators (such as number of applications completed, percentage of enrollments resulting in coverage, etc.)

Assessing overall compliance with program standards and guidelines.

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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Additional details about ongoing performance monitoring are provided to the CEE points of contact.

6. STAGE II: CERTIFIED ENROLLMENT COUNSELOR ROLE In this stage you will learn the next steps for CECs after they have completed training. It will describe taking CoveredCA.com system training, completing the certification exam, working with your CEE to start performing work and recertification requirements.

6.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Describe requirements for completing online CoveredCA.com system training

Describe requirements for taking certification exam

Understand the steps required to start your work

Describe requirements for recertification

Describe the support that exists for counselors after certification

7. LESSON 5: WHAT ARE THE NEXT STEPS AFTER CECS COMPLETE TRAINING? 7.1.1. NEXT STEPS

Once the training is complete for CECs there are several next steps to become officially certified. These steps in the certification process include:

Steps to Certification

Step 1 Completing online CoveredCA.com system training

Step 2 Independently studying the participant guides

Step 3 Taking an online certification exam

Step 4 Working with your CEE to develop a plan to start work

Step 5 Becoming recertified as required

1. Completing online CoveredCA.com system training

One of the most important tools that CECs will utilize is CoveredCA.com

CoveredCA.com will allow CECs to easily perform the functions of their job

The CoveredCA.com training will include the following courses:

o Creating an Account for Counselors – This course will teach counselors how to create an account in the

system. Counselors will use this account to do all activity in

Covered California Participant Guide Course Name: Certified Enrollment Counselor Role Version 2.0

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CoveredCA.com and will be the central location where all eligibility and enrollment activities are tracked.

o Individual Applications and Enrollment for CECs

– This computer-based training module provides CECs with instruction in assisting Individual users with the application, enrollment, and case management processes. The course covers topics including:

– anonymous screening for potential eligibility

– completing the online application

– understanding eligibility results and submitting verifications

– plan comparison and selection

– withdrawing an application

– maintaining Individual accounts

– completing annual renewals

o Reporting for CECs

– This computer-based training module provides CECs instruction regarding accessing and using reports. The course will instruct the user in various financial, operational, Federal, State, and management reports.

The CoveredCA.com training will be administered online through the Learning Management System (LMS) used to schedule training.

The training will be delivered through self-paced Computer Based Training modules.

CoveredCA.com training will be available to students on the last day of training in the computer lab or online from work or home at the student’s convenience.

This training offers specifics on the Covered California program and policies.

2. Independent studying of the participant guides

Following the completion of this training and the CoveredCA.com online training, students should spend time studying the participant guides provided in the student binder.

The exam is composed of questions from each of the modules covered in training and answers to the exam come directly from the participant exam. Although the exam is open book, students are expected to have a concrete understanding of all program materials.

Covered California recommends that students spend no less than 8 hours studying for the exam.

3. Completing the online certification exam

The exam will be delivered online through the LMS

The certification exam will be 50 questions

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Students are expected to pass the exam with a score of 80% or better on each of the modules

Tips for Passing the Certification Exam

Tip #1 – Prepare through independent and group study with peers.

Tip #2 – Make sure that distractions are minimized when taking the test.

Tip #3 – Take time to read and understand each question completely before answering

4. Developing a plan to start work Following successful completion of the exam, you will obtain your certificate and receive notification from Covered California of the next steps to be able to start work assisting consumers with enrollments.

You should work with your supervisor to develop a plan to assist consumers consistent with your organization’s objectives and the population served. This includes:

Understanding how to generate leads

Following up on leads to schedule appointments

Turning appointments into successful enrollments

5. Becoming recertified Each year CECs are expected to complete the annual recertification training and exam.

In addition, throughout the year CECs will be required to participate in program updates as they become available.

Covered California will provide your organization additional details as they become available.

8. LESSON 6: WHAT SUPPORT EXISTS FOR CERTIFIED ENROLLMENT COUNSELORS?

There are a number of resources and support mechanisms to assist CECs in day-to-day activities.

8.1. LEARNING OBJECTIVES At the end of this lesson you will be able to:

Identify who and what support resources are available

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8.1.1. WHAT SUPPORT EXISTS FOR CERTIFIED ENROLLMENT COUNSELORS? After training, there are many resources available to CECs both for support in day-to-day activities and for in-depth education on health care reform, Covered California, and government agencies.

There are three different types of resources: Resources for CECs Educational resources Contacts

Resource Benefit

Certified Enrollment Counselor Training Manual

Reference guide for working as a Certified Enrollment Counselor for Covered California

Job Aids Quick reference for key information like contacts and other often-needed details

Enrollment Counselor Help Desk: 1.888.402.0737 [email protected]

Enrollment Counselor technical support Issues that need escalation

Grantee Help Desk: 1.866.622.5252 [email protected]

Outreach and Education Team Support Issues that need escalation

Covered California Service Center 1.888.975.1142 Staffed with representatives who speak in multiple languages

Consumer or Enrollment Counselor questions about applications/enrollment

Covered California Health Plans Consumer help with healthcare claims, accessing doctors or care, etc.

Covered California 560 J Street, Suite 290 Sacramento, CA 95814 1.888.957.1142

Consumer complaints or issues regarding a Certified Enrollment Counselor or Enrollment Entity.

https://learning.coveredca.com/Default.aspx

Learning Management System, ongoing database for training needs.

Educational Resource Reference

Federal health care reform www.healthcare.gov www.healthcare.gov/center/regulations/index.html

The Centers for Medicare and Medicaid Services’ Center for Consumer Information and Insurance Oversight

http://cciio.cms.gov/

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California Health Benefit Exchange www.healthexchange.ca.gov

Department of Managed Health Care (DMHC) and its programs

www.dmhc.ca.gov

Medical Risk Management and Insurance Board (MRMIB) and its programs

www.mrmib.ca.gov

Office of the Patient Advocate www.opa.ca.gov

Contacts As a Certified Enrollment Counselor, you will likely be asked questions or have situations for which you need additional support. This quick-reference list provides contact information for many common situations. In addition, the Contacts and Resources Job Aid is a great tool to have at your desk, as it includes all the Covered California contact information you may need.

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Certified Enrollment Counselor Activity Support Who to Contact

Questions about your day-to-day activities

Your immediate supervisor at the Certified Enrollment Entity with which you are registered

Trouble connecting to or using CoveredCA.com, the Covered California online portal

Covered California Service Center

1.888.975.1142

Application questions Covered California Service Center

1.888.975.1142

A small-business owner wants help reviewing his health insurance options for his company

Certified Insurance Agent―if they want to look at several health insurance company options

An individual is having a problem with their insurance benefits or something related to their current coverage

Covered California Service Center

1.888.975.1142

Note: The consumer may be transferred to their health insurance company’s complaint unit or to the appropriate state regulatory entity.

Office supplies or other on-site needs Your Certified Enrollment Entity

8.1.2. ACTIVITY 1 Check your knowledge of the Certified Enrollment Counselor role basics by answering true or false for each statement. True False

1. Certified Enrollment Counselors can enroll consumers in Covered California health plans.

2. Certified Enrollment Entities have the option of targeting specific markets or populations and turning away others who ask for assistance.

3. The primary goal of the Certified Enrollment Counselor role is to provide in-person assistance to consumers as they sort through health insurance options and make the right choice.

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8.1.3. ACTIVITY 2 Check your knowledge about the Certified Enrollment Counselor program by circling the correct answer.

Answer

1. Which of the following are requirements to be a Certified Enrollment Counselor? a. Get certification by Covered California b. Complete required training courses c. Sign a code of conduct d. Be affiliated with a registered Certified Enrollment Entity e. All of the above

2. Certified Enrollment Counselor services include: a. Assisting consumers with completing eligibility requirements

for all Covered California products and programs b. Supporting retention efforts including coverage renewals c. Providing information to the media about Covered California d. Serving all consumers in a fair, impartial, and respectful

manner e. All but C f. All of the above

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9. ACTIVITY ANSWERS Activity 1 Answers:

1. True 2. False 3. True

Activity 2 Answers:

1. E 2. E