Fewer guides help navigate health plans

Trace Henley, a network-relations specialist with Washington Regional Medical Center’s Health Partners, works with Floyd White of Fayetteville as he switches his health insurance carrier Friday at Health Partners in Fayetteville.
Trace Henley, a network-relations specialist with Washington Regional Medical Center’s Health Partners, works with Floyd White of Fayetteville as he switches his health insurance carrier Friday at Health Partners in Fayetteville.

Open enrollment for Arkansas health plans sold on the federal Health Insurance Marketplace started Nov. 15, but finding enrollment help in the state could be more difficult than it was last year.

The Arkansas Insurance Department ended contracts with 27 agencies in the state that employed about 530 "guides" trained to help the public enroll, said Seth Blomeley, spokesman for the department.

The contracts ended July 1 after an amendment to the department's appropriations bill that banned it from using state, federal or other funding for outreach and education activities to promote enrollment in the marketplace, Blomeley said.

As of Wednesday, a federal website set up to help residents enroll in the marketplace had not been updated to show changes in state services. A click on a website tab titled "Find Local Help" sends users to a page still listing many of the agencies no longer offering services after the Insurance Department ended their contracts.

Federal officials have been notified of the changes in services offered in the state, Blomeley said.

Officials hope that previously trained guides will continue to provide services, Blomeley said. It is possible that some agencies will decide to cover the costs of the guides on their own, he said. The guides could also find employment elsewhere.

Guides must be licensed to provide enrollment services in the state and must be re-licensed each year. This year's licensing deadline had been Sept. 30 but was extended to Dec. 14 because of a delay in federal training materials, Blomeley said.

Open enrollment in the marketplace closes Feb. 15.

The total number of people licensed to help residents enroll in the marketplace is likely to decrease this year because many guides will not renew their licenses, Blomeley said.

There were 2,106 people licensed to enroll people in the marketplace during the enrollment period last year, Blomeley said. As of Monday, 1,325 people had been licensed for this enrollment period.

In addition to "guides," the state describes those licensed to help with enrollment as "producers," "navigators" and "certified application counselors."

The "producers" group includes agents or brokers who make commissions from enrolling individuals into insurance plans, Blomeley said. There are 1,031 producers licensed, making it the largest group helping with enrollment.

The other licensees include 237 certified application counselors, 41 guides, and 16 navigators.

A list of agents and brokers was recently updated on the Arkansas Health Connector website, a portal run by the Arkansas Insurance Department to provide information about health care plans found on the federal marketplace.

Certified application counselors are typically employed by hospitals or doctors offices, Blomeley said. The health care providers have traditionally employed counselors to help people enroll in Medicare and Medicaid. In many cases, these employees became certified as application counselors after the rollout of the Patient Protection and Affordable Care Act.

Guides, navigators and certified application counselors can share information about the enrollment process but are not allowed to suggest plans, as producers are allowed to do, Blomeley said. Many times agencies that directly or indirectly receive federal funding employ guides and navigators.

Two organizations in the state have received direct federal funding to provide enrollment services, Blomeley said. They are the Arkansas Navigator Coalition through the University of Arkansas and the Enroll the Ridge program in Jonesboro.

David Armistead Wright, co-director for the Arkansas Navigator Coalition, said the program was awarded $774,000 Sept. 8. The grant will run through Sept. 7, 2015.

Armistead Wright said the organization has its own outreach events, but it also sends navigators to events hosted by other organizations in the state.

"We use the funding to support navigators in all regions of the state," Armistead Wright said.

The program also awarded three sub-grants to organizations meant to supplement the cost of employing a navigator, Armistead Wright said. Legal Aid of Northwest Arkansas, The Daughters of Charity Services of Arkansas and the Greater Delta Alliance for Health all received the grants.

The elimination of 530 guides in the state will make it harder for people to receive help, Armistead Wright said.

"It is a huge change, but that just means we have to step up our game and offer more events and more ability for people to get enrollment," Armistead Wright said.

Blomeley said there are several reasons why people seek enrollment services.

"A lot of people just aren't used to using a computer," Blomeley said. "Health insurance also can be very complex. Even for people in the industry, it is hard to sort through everything and learn about everything."

Some people just want the one-on-one help with signing up, Blomeley said.

Floyd White of Fayetteville met Friday with Trace Henley, a certified application counselor with Health Partners, a Washington Regional Medical Center program.

White said he wanted to find a new plan that his family doctor will accept. His current plan, purchased off the exchange earlier this year, will not be accepted by his doctor in the future.

It was easier to sit down with Henley to find a plan than to do it on his own, White said. He said he doesn't have a computer at home.

Northwest Health Systems in Bentonville and Springdale also employ certified application counselors.

Sharif Omar, CEO of Northwest Health System, said it is another way to make sure that people in the community have access to health care.

"It always has and will be our goal to get as many people as we can the care they need," Omar said.

Helping people sign up for health insurance helps not only the Northwest Health System but also the community, Omar said.

The hospital system is able to help people sign up in two ways, Omar said. Residents can call the hospital and set up an appointment, he said. Staff members can also direct patients without insurance to enrollment assistance provided by the hospitals.

NW News on 11/27/2014

Upcoming Events