Uncle California black bear wants you!
Covered California held another webinar to discuss updates to proposed regulations for In-Person Assisters (IPA) and Navigators. With each webinar of information the assistance programs to enroll upwards of 5 million Californians into health insurance plans becomes a little clearer, at least for some of us. Download presentation slides -> [download id=”61″]
Covered California In-Person Assister army
The effort to assemble a force of an estimated 21,000 individuals to assist millions of Californians without health insurance to enroll through Covered California is nothing short of building a small army. Covered California will supply the boot camp for new recruits while they are hoping friendly organizations and nonprofits will provide the bulk of the recruitment.
Assister Entity umbrella to IPA
The In-Person Assister program will launch first. At the beginning of summer they hope to roll out the Assister Entity Application. The goal is to have approximately 3,000 entities like nonprofits that will be the umbrella organization for the actual IPAs. Once the Assister entity is approved they will then attend Assister Enrollment Entity training during the summer.
Summer IPA training
At around the same time, individuals can apply to be an IPA but they must register themselves with an Assister Entity. The training for the IPAs is proposed to commence in August. When an IPA assists an individual or family and the application is successful, meaning when coverage commences January, 2014, the Assister Entity will be paid $58. An IPA can be associated with more than one entity.
Attention! IPA recruits!
Covered California will be running the induction of new recruits and “boot camp” training. To become an IPA a person must pass a finger printing and criminal background check, attend a 2 – 3 day training session and pass an exam. There will also be an appeals process in case someone is denied acceptance because of a typo on the application.
Navigators perform outreach and education
Concurrent with the IPA program will be the Navigator program. The big difference between an IPA and a Navigator is that Navigators will be responsible for performing outreach and education. But as I understand it, the Navigator outreach and education is separate from specific grants designated for public relations campaigns to create awareness about ACA open enrollment. An organization can’t be both an Assister Entity and a Navigator.
Navigators compensated with grant money
Navigators, which will be nonprofits and organizations like the Assister Entities, must submit a grant application which will be released in late June. Covered California hopes to award the Navigator grants early October and then offer training and certification in November. The goal is to have the Navigator program running in early December. Navigators won’t be compensated based on enrollment but through the grant award and their performance in meeting enrollment goals.
Do you have what it takes to be an IPA?
Virtually any adult can be an In-Person Assister or Navigator, assuming he or she can pass the background check, but not everyone is eligible to receive compensation for a successful enrollment. Any person or organization that receives money from insurance companies is not eligible for compensation: insurance agents, brokers, hospitals, doctors, labs, imaging and surgery centers. People in these occupations or affiliated with providers can go through the IPA or Navigator training and enroll people; there just won’t be any Covered California compensation for their efforts.
Insurance agents wondering what their role will be
There seemed to be several insurance agents and brokers, like myself, that were able to ask questions during the webinar. To the relief of many, insurance agents can go through the IPA and Navigator training. They won’t be compensated for successful enrollments. While the issue is still a little murky, it sounds as if there will be compensation paid directly from the insurance carrier, either individual or small group, when enrollment is processed through Covered California. This means some tracking fields need to be built into the Covered California application for both on-line and paper apps.
Is assistance transacting insurance?
One insurance agent, who had a little edge to his voice, asked how an IPA is different from an actual insurance agent. The point being that in California you can’t “transact” an insurance sale without a license. Transaction as defined as executing a contract, negotiations, solicitation or transactions that later result from the operation of the contract. The moderator answered that IPA’s were assisting people with enrollment. I empathized with the caller’s concern because as an agent we have to pay to be licensed, perform continuing education and carry errors and omission insurance.
Exemptions in the regs
California insurance regulations already exempt entities that assist with enrollment to the Healthy Families and the Major Risk Medical Insurance Program from having to hold an insurance license. So, it is no surprise that IPAs will be exempt from the regulations as well. In addition, IPAs can’t recommend a specific insurance plan; they can only discuss the options and benefits.
Will we get uniforms in the IPA army?
Will Covered California be able to build an army of Assisters and Navigators to enroll millions of uninsured Californians? There seems to be many interested organizations that are willing to step up to the plate to be an Assister or Navigator Entity. Several big questions are: can those organizations recruit enough people, can they pass the test and can Covered California pull off the boot camp training? A good army unit will adapt to changing field conditions. Let’s hope Covered California has a good officer corp to lead the charge.