We are in our eleventh year of open enrollments made possible by the Patient Protection and Affordable Care Act , commonly known as the ACA. This post is for the enrollment assisters around the country doing the important work of outreach and enrollment. At Transform Health, we believe outreach and enrollment work is central to health systems change because we know that accessing affordable, quality health coverage is the first step to addressing health care inequities and driving systems change to create healthy communities.

We recognize that many nonprofits doing enrollment work may have limited funds, and in honor of OE11, Transform Health is offering a free, one-hour consultation to address your outreach and enrollment strategy and planning needs. To sign up for your free consult with no strings attached, please fill out our contact form and we will be in touch with you to schedule a convenient time that works.

Resources in Heavy Rotation

We’ve curated a list of our favorite resources in heavy rotation. Make sure to bookmark these links on your browser and please share with others.

The Center on Budget and Policy Priorities Beyond the Basics webinar series is a must-have to learn about:

• Determining household income
• Data matching errors and what to do about them
• Plan selection strategies, and more.

Some of our all-time faves to accompany your consumer appointments include CPBB’s plan comparison worksheet and the quite popular yearly income guidelines and thresholds reference sheet. The plan comparison worksheet is available in eight languages and helps to organize plan details so that consumers can compare plans side by side before enrolling. The yearly income guidelines and thresholds document provides a quick reference to assist in assessing a client’s income for potential eligibility for premium tax credits through the Marketplace.

The Georgetown Center on Health Insurance Reforms Navigator Resource Guide. This is a must-have for everyday life as an enrollment professional helping consumers with qualified health plan selection on the marketplace. Check out their state-based fact sheets and FAQs about health coverage.

• People without any coverage
• People with coverage
• Information for small business employers
• Post-enrollment issues to look out for

“The Ohio Association of Foodbanks Navigator consortium is gearing up for another busy Open Enrollment season! Our team has become a trusted resource in the state through partnerships with a wide range of community partners, including public health departments, health care providers, small businesses, financial advisors, and many more. Many Navigators are already reporting a busy schedule of repeat clients, some of which they’ve assisted for the last three years!” – Grace Wagner, Ohio Association of Foodbanks

Understanding Coverage Embedded in Your Enrollment Appointment

Did you know that healthcare.gov, managed by the Department of Health and Human Services (HHS), is more than just a place to select a qualified health coverage plan? On healthcare.gov you can also find quick answers to common questions and some gold nuggets for your consumer appointments in multiple languages— without applying for coverage. If you need more detailed information, CMS.gov is the official home of the Marketplace information for assisters and outreach partners. And if you are looking for a state that has its own marketplace, you can find those here.

The annual healthcare.gov Window Shopping Tool provides a preview of the plan benefits and coverage available to consumers and can be used if a consumer isn’t quite ready to enroll but wants a general sense of their options. It is available now with 2024 plan information, including plan directories of in-network providers, formularies of covered medications, and detailed information on deductibles, out-of-pocket maximums, copays, and co-insurance. Assisters interested in a full walkthrough of the tool can view this step-by-step video below.

Coverage to Care Materials for Educating Consumers

We would be remiss to not mention the partner toolkits and Coverage to Care materials produced by the Centers for Medicare and Medicaid Services (CMS). The C2C materials can be used to follow-up with consumers, explain the value of having health insurance coverage, and facilitate meaningful conversations about confusing terms at events and appointments. We are big proponents of the C2C library and highly encourage incorporating these tools into your workflows. We specifically like:

• FAQ for Accessing Care
• Partner Toolkit, which can be used to educate community partners and increase referrals to your enrollment services
• Roadmap to accessing care and services, the basics of using coverage

Enrollment Assistance for Lawfully Present Immigrants

Do you provide enrollment assistance to clients who are immigrants? If so, you will want to have the resources available through Protecting Immigrant Families (PIF) on hand. PIF provides information in multiple languages, presented clearly for both assisters and consumers. The chilling effect on enrollment due to Public Charge concerns is still with us, and consumers may be hesitant to apply for health coverage. The Herlinda Letter is an enrollment tool aimed at supporting assisters to relay facts in a way that consumers can take action.

“Navigators are ready to be able to assist people with their 2024 coverage as well as continue helping with navigating Medicaid unwinding to ensure that as many Floridians as possible have access to affordable health care.” – Jodi Ray, University of South Florida Navigator Program

Young Invincibles

Not only are they home to The Connector, an appointment setting tool for outreach, but Young Invincibles also has a national Get Covered Coalition, where assisters can compare notes and best practices, as well as media kits targeting Medicaid Unwinding populations and shareable graphics tailored for outreach during and outside of the Open Enrollment Period.

“Our outreach and enrollment team at Westside Family Healthcare just completed our 11th annual open enrollment training. We covered everything from appointment scheduling to story banking and best practices for adhering to federal policies. We have a good mix of new and experienced assisters, both Navigators and Certified Application Counselors, who are all excited to kick off this open enrollment period.” – Tina Gaffney and Sara Hart, Westside Family Healthcare Navigator Program, Delaware

Out2Enroll

Need information about serving the LGBTQ community? Out2Enroll has you covered. Check out their free assister training and become an expert!

Kaiser Family Foundation

Navigators all over the country know that Medicaid Unwinding is still underway during open enrollment. Kaiser Family Foundation’s resource is tracking Medicaid Unwinding data and trends happening around the country.

We hope you are able to take advantage of all of these free resources during this open enrollment, and beyond. Happy Open Enrollment!

“As we prepare for another Open Enrollment Period it’s important that we remember our mission in service to the community, that we never underestimate the impact of our work, and the importance that we have in our healthcare system. We are not doctors or nurses but the work we do matters, and we literally save lives and change family trees.” – Jose Ibarra, CentroMed, Texas