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Wednesday, February 17, 2016

Sharing Lessons Learned and Savoring Success: Enrollment Assisters at Health Action

Kyrstin Racine

Enrollment Intern

Heather Bates

Director of Community Engagement

For the first time in its 21-year history, Families USA’s annual Health Action conference offered an enrollment assister track for people who help consumers enroll in Affordable Care Act (ACA) marketplace coverage. The track attracted navigators, certified application counselors (CACs), and enrollment program managers from across the country. Taking place just days after the close of open enrollment, Health Action 2016 gave assisters a chance to celebrate their successes. Here is a quick run-down of the highlights for assisters, in case you missed it. 

The Future of Enrollment: Applying Lessons Learned and Planning Ahead 

This past open enrollment period was the most successful since the passage of the ACA, thanks in large part to the assisters who worked tirelessly to enroll millions in coverage. Previous research has indicated that consumers who receive assistance when selecting a health plan are more than twice as likely to enroll in coverage, which further validates the need for in-person assistance.  

The ACA is new, but enrollment assistance is not. Experts who have been finding consumers to enroll in other health insurance programs such as Medicaid and CHIP were hard at work long before the ACA and “didn’t have to reinvent the wheel,” according to speaker Jodi Ray, program director at Florida Covering Kids & Families.

The speakers emphasized that trusted community partners remain the key to successfully reaching consumers and enrolling them in coverage.  

Daphne Pie, access and outreach manager of Seattle’s King County Department of Public Health, underscored the importance of creating strategic plans for targeted outreach and recognizing when and how to include partners.  

Looking ahead, assisters agreed that the following areas are high-priority areas for their programs: 

Enrollment Policy Deep-Dive: Staying In-The-Know 

Some of the most complex questions assisters face involve tax credits, reconciliation, and marketplace appeals. The session helped to clarify how assisters can connect consumers to free tax preparation services. Other takeaways included: 

  • Consumers can appeal numerous marketplace eligibility determinations, including eligibility determinations, the amount of APTCs (premium tax credits) a consumer receives, and eligibility for an exemption.  
  • Consumers should appeal as soon as possible, but no later than 90 days after a marketplace determination. 

Most notably, winning their appeal for marketplace eligibility is the only way a consumer can obtain retroactive coverage for private insurance (for enrollment in a qualified health plan through the marketplace).  

Stay Motivated, Be Creative: Help Your Staff Grow

Enrollment work is demanding, and it is important for assisters to take care of themselves to avoid burnout. During this interactive session, enrollment assisters and program managers learned how to cope with stress and some tactics for setting limits in the work day. Many of us already do these things, but some of the exercises you could try with your staff included: 

  • Energy zappers: how much energy do you have left in the day? 
  • Balloon exercises to relieve stress  
  • Writing down three good things that happen every day for two weeks 

If you want to know how to do these exercises with your staff, email us at 

Caroline Gomez-Tom, a navigator program manager with Covering Kids and Families Wisconsin, said that “this workshop was worth its weight in gold,” noting that it is often challenging to “take care of yourself, recognize your staff, and make sure time is given to appreciate the successes your organization accomplishes as a team. This session highlighted some great ideas to support staff and promote healthy work/life balance.” 

Enrollment Is Year-Round: Maximizing Time between Open Enrollment Periods 

An enrollment assister’s job doesn’t end with open enrollment. Post-enrollment work in the form of following up with consumers about how to use their coverage continues throughout the year. Presenters emphasized the importance of data-driven planning, staff training, and customer care in keeping enrollment programs strong. 

Consumers also need help identifying special enrollment periods, filing appeals, finding primary care providers, filling out Medicaid/CHIP applications, and other tasks related to maintaining and using health coverage.  

When they aren’t directly working with consumers, assisters are building bridges with community partners and developing outreach strategies to reach the remaining uninsured. You can see more of the work assisters are doing before, during, and after open enrollment on social media using #Enrollment365.  

The Convening Role: How to Host an Effective Debrief 

Debrief meetings about how open enrollment went are an important part of assisters’ annual initiatives. In these scheduled meetings, program managers, assisters, and other key players meet to reaffirm successes and evaluate areas for improving their enrollment efforts. During this session, attendees learned about conducting a concise but effective debrief. Some important tips included: 

  • “Begin with the end in mind.”—What data is important to gather during the debrief? What do assisters need to escalate their efforts? 
  • Survey assisters before the meeting to understand what issues they feel need to be addressed. 
  • Present a road map at the beginning of the debrief meeting to keep the conversation on track and illustrate how far an assister program has come. 
  • Recognize that problems are what most of us gravitate toward, but emphasize solutions during the meeting and have a parking lot for subjects that require more time. 

Debrief meetings are a chance to reflect on the successes and challenges as a whole, and provide direction for enrollment programs as they create strategic plans for the next open enrollment period. Listen to this recording of the Families USA webinar about debriefs held on February 18.

Assisters are advocates 

Assisters don’t always think of themselves as advocates, but they have an important role to play in educating the public and policymakers about what they do, the impact they have in their communities, the partners they bring to the table, and whom they help to enroll. Families USA recently released the Public Policy Toolkit for Enrollment Assisters, which explains how assisters can educate public officials on issues that matter to them and the consumers they serve.  

In sum, enrollment assisters who attended Health Action were able to participate in professional development and skill-building. The selection of workshops gave assisters opportunities to strengthen their voice for building and maintaining effective partnerships, handling complex enrollment questions, and improving staff retention. Most importantly, they were able to learn from each other and savor the accomplishments of the third open enrollment period.