Pennsylvania Association of

Community Health Centers

Supporting Pennsylvania's health centers in increasing access to quality primary health care for all

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April 6, 2018 Outreach and Enrollment News

CMS Releases Final Open Enrollment Numbers

11.8 million consumers enrolled in the Health Insurance Marketplace according to the Centers for Medicare & Medicaid Services (CMS) final report published on April 3, 2018. This is a slight decrease from the 12.2 million consumers who enrolled in 2017. The largest portion of consumers were returning from the previous enrollment period.  The demographics show the average consumer was between 35-54, chose a silver plan and paid an average $153 premium after receiving advance premium tax credits (APTCs). In Pennsylvania, 389,081 individuals enrolled in coverage for 2018, down 9% from 426,059 in 2017. See the CMS Final Report


TIPS for Handling PII

Navigators and certified application counselors (CACs) providing Marketplace enrollment assistance are permitted to create, collect, disclose, access, maintain, store and use consumer personally identifiable information (PII) only to perform functions that they are authorized to perform as assisters.  Prior to collecting PII or other information from consumers in connection with carrying out your Navigator or CAC duties, you must provide the consumer with a written privacy notice statement that has been developed by your organization.  When assisting a homebound consumer over the phone, you must read the consent, ensure it is consistent with the privacy policy and maintain a copy.


Refugee Medical Assistance

In Pennsylvania, Refugee Medical Assistance (RMA) provides the same level of benefit to individuals as Medicaid and is considered part of thePennsylvania Medicaid program, though it is funded differently. RMA provides basic health care to those recently-arrived who do not qualify for other federally-funded Medicaid programs in order to encourage their rapid move toward economic self-sufficiency. The RMA application process officially begins on the date of application: that is, the date the application for benefits (PA 600) is complete, signed in at least one location, and received by the county assistance office (CAO). In most areas of the state, the refugee or resettlement agency (RA) assists in the completion the PA 600 and faxes, emails, or submits it via COMPASS.  RMA applicants will need to provide verification of required non-financial and financial eligibility, proof of refugee or other qualifying immigration status, date of entry to the U.S. (for asylees, date asylum was granted; for victims of trafficking, certification date); and name of his/her voluntary RA. See the Department of Human Services Refugee Assistance Program Memo for more information.


Marketplace Consumer Tax Questions Answered

Tax season is upon us and consumers may be coming to you to ask questions about their 1095-A, the cost of the penalty and how to request an exemption for lack of coverage in 2017.  This chart will assist you with directing consumers to the appropriate expert for these complex questions.  Remember, assisters should not be providing tax advice or help, but should refer consumers to the IRS or their local tax preparer. 
  • 6 April 2018
  • Author: Amanda Tekely
  • Number of views: 41
  • Comments: 0
Categories: Outreach News
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