Outreach & Enrollment Tips and Tools

Listed below are some great tips and tools to help ensure an effective outreach and enrollment program.

Click or scroll down for:

Marketplace Outreach and Enrollment
Medicaid Outreach and Enrollment
SHOP Outreach and Enrollment
Renewal Resources
Tax Filing Resources
Tips and Tools for Successful Outreach and Enrollment
Post-Open Enrollment
Toolkits for Outreach and Enrollment
Region VIII PCA Outreach and Enrollment Websites

Flyer and postcard advertising health centers’ enrollment services
Colorado Flyer and Postcard
Montana Flyer and Postcard
North Dakota Flyer and Postcard
South Dakota Flyer and Postcard
Utah Flyer and Postcard
Wyoming Flyer and Postcard

Please email the CHAMPS Programs Coordinator, Population Health if you would like a file in a different format

CHAMPS created a picture guide of the different forms of identification that consumers can use to prove citizenship, immigration status, and identity when applying for coverage on the Marketplace
Sample Documents to Prove Citizenship, Immigration Status, and Identity on the Marketplace

 

MARKETPLACE OUTREACH AND ENROLLMENT

CMS Extends Open Enrollment Period for Healthcare.gov and Launches Initiatives to Expand Health Coverage Access Nationwide
Information on Open Enrollment Period for Healthcare.gov
https://www.cms.gov/newsroom/press-releases/cms-extends-open-enrollment-period-and-launches-initiatives-expand-health-coverage-access-nationwide

Specific information on 2015 rules for Navigators, CACs, and non-Navigator assistance personnel in federally facilitated and state partnership Marketplaces (May 2014)
Overview for Assisters of Exchange and Insurance Market Standards for 2015 and Beyond

FAQ on identity proofing issues (May 2014)
FAQ on Identity Proofing

Information on the new 2015 Market Standards Rule for federally-facilitated and state-partnership Marketplaces (March 2014)
2015 Market Rules

Slides on how to help family members enroll in separate marketplace plans (March 2014)
Tutorial: How to Enroll Family Members into Different Marketplace Plans

FAQ on payment and eligibility issues (January 2014)
Helping Consumers with Payment and Eligibility Issues

A quick reference for states using the Federally Facilitated Marketplace (FFM) which includes consumer assistance and outreach and education resources (September 2013)
Health Insurance Marketplace Educational Resources for States, Consumers, and Other Stakeholders

Healthcare.gov website in Spanish
CuidadoDeSalud.gov

Slides for assisters on how to process complicated applications
Processing Applications: Multi-Tax Households

Website to order marketplace paper applications for your organization – click ‘Request an Account’
Product Ordering Website

Widgets and badges for the health insurance marketplace to use on your website or blog
Widgets and Badges

Center on Budget and Policy Priorities
Tips from CBPP on how to help consumers resolve inconsistencies with the Marketplace (July 2014)
All Hands on Deck Needed to Help Consumers Resolve Inconsistencies

Enroll America
Resource guide for people who are helping consumers enroll in health insurance plans (November 2013)
Application Assistance 101: Helping Individuals Sign Up for Health Insurance

Families USA
Timely analysis and resources on policies that affect enrollment, public education, outreach and communication strategies, and tactics from around the country, created at the state, national, and federal levels.
Enrollment Assister Resource Center

Healthcare.gov
Sample Eligibility Determination Notices (EDNs) for consumers required to complete SEP eligibility verification (July 2016)

Adoption/Foster Care/Court Order Placement SEP Verification
Birth SEP Verification
Change in Place of Living SEP Verification
Loss of Minimum Essential Coverage SEP Verification
Marriage SEP Verification

Privacy information the user agrees to when submitting an application on the marketplace
Privacy Act Statement

In the Loop
A fact sheet for enrollment assisters outlining grace periods that ensure continued coverage for consumers who receive Advanced Premium Tax Credits (APTCs) while they catch up on overdue premium payments (updated July 2018)
Grace Periods

Justice in Aging
Fact sheet on what older adults need to know about Open Enrollment periods for both Medicare and the Health Insurance Marketplaces (October 2017)
Open Enrollment through Medicare & the Marketplace

Kaiser Family Foundation
Tool that estimates total health care costs for each plan level based on utilization of certain types of services and medication costs.
Health Insurance Marketplace Calculator

Kaiser Health News
Description of innovative strategies some states are using to raise awareness of the new health insurance marketplaces (August 2013)
States Use Out-of-the-Box Approaches to Raise Awareness of Health Exchanges

Moms Rising
Messaging, shareable images, and sample social media posts in Spanish and English (October 2019)
Open Enrollment 7 Toolkit

National Association of Community Health Centers (NACHC)
A Google Drive folder containing social media graphics, one-pagers, fact sheets, videos, and other materials for outreach to consumers. The materials are all un-branded and many are editable for organizations to add additional information such as contact information, location, and logos. Includes resources in different languages (October 2018)
Open Enrollment Resources

National Disability Navigator
Information to help assisters answer questions about benefits and coverage through the marketplace
Comparing Health Plans’ Benefits and Coverage Summaries

Fact sheet on answering questions about getting and using evidence of coverage documents
Getting and Using Health Plan Evidence of Coverage

National Health Law Program
A fact sheet laying out the grounds for appeals and explains where individuals should go for assistance
Marketplace Casework, Complaints, and Appeals

U.S. Department of Health and Human Services (HHS)
A checklist to help consumers gather necessary information to apply for coverage
Marketplace Application Checklist

Marketplace applications in 15 different languages
Marketplace Consumer Application

MEDICAID OUTREACH AND ENROLLMENT

Centers for Medicare and Medicaid Services (CMS)
Q&A on the shared responsibility payments for Medicaid and CHIP (March 2014)
Shared Responsibility Provision Question and Answer

Community Health Association of Mountain/Plains States (CHAMPS)
A resource for Region VIII Outreach & Enrollment staff with Medicaid enrollment information by state the government agencies which manage the state’s Medicaid program, the name of that program, links to each application site, and CMS online and print resources (October 2017)
Medicaid Enrollment Information, Including Medicare Shared Savings Plans & CMS Resources

Enroll America
Blog post on reaching people in non-expansion states (March 2014)
How to Help Residents in States That Are Not Expanding Medicaid

Connecting SNAP recipients to Medicaid to simplify enrollment: lessons from Arkansas (October 2013)
Is Snail Mail the Key to Modernizing Enrollment?

Healthcare.gov
Information on continuous Medicaid and CHIP enrollment (April 2014)
Still Open: Coverage in Medicaid and CHIP

Kaiser Family Foundation
Information on best practices for Medicaid/CHIP outreach (June 2013)
Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act

National Academy for State Health Policy (NASHP)
Highlights current initiatives that focus on effective partnerships, social media use, and other approaches that states can borrow from and enhance their CHIP and Medicaid enrollment efforts (July 2019)
A Snapshot of State Efforts to Reach and Enroll Children for State Medicaid and CHIP Programs

SHOP OUTREACH AND ENROLLMENT

Healthcare.gov
Calculator to determine if an employer is eligible for SHOP
SHOP Full-time Equivalent Employee (FTE) Calculator

Calculator to determine if a business is eligible for tax credits
SHOP Tax Credit Estimator

RENEWAL RESOURCES

Consumers who enrolled the previous open enrollment period do not need to reapply for coverage each subsequent open enrollment period: however, they are encouraged to return to the Marketplace to update their personal information and explore their plan options. Consumers who do not revisit the Marketplace to select a new plan or update their information will be automatically enrolled in the same plan they selected the year before, or a similar plan if their current plan is being discontinued.

Centers for Medicare and Medicaid Services (CMS)
A guide to redetermination and re-enrollment geared towards assistance staff (November 2016)
The Assister’s Roadmap to Resources

Proposed rule for 2016 on eligibility redeterminations for existing Marketplace customers in federally-facilitated Marketplace states (May 2015)
Guidance on Annual Eligibility Redeterminations and Re-enrollments for Marketplace Coverage for 2016

Health and Human Services (HHS)
Press release from HHS announcing auto-enrollment plans, with links to the full text of the proposed rule (June 2014)
HHS announces auto-enrollment plans for current Marketplace consumers for 2015

Enroll America
Fact sheet for assisters on streamlining the plan renewal process in order to minimize gaps in coverage (June 2014)
Five Recommendations To Make Renewal a Success

Blog post with information on renewal dates for current Marketplace customers (June 2014)
New Guidance on Keeping Marketplace Enrollees Covered for 2015

Georgetown University Health Policy Institute
Guidelines for streamlining Medicaid and CHIP renewal (April 2014)
Renewing Medicaid and CHIP Under the Affordable Care Act

Robert Wood Johnson Foundation
Report detailing the experiences of CA, CO, KY, MD, RI, and WA navigating the plan renewal process in 2014, and recommendations for upcoming open enrollment periods (July 2015)
Six State Experiences with Marketplace Renewals: A Look Back and a Glimpse Forward

TAX FILING RESOURCES

2021 Tax Season began Monday, February 12, 2021, and will run through Monday, May 17 (this is a postponement from the traditional closing date of Wednesday, April 15 due to the COVID-19 pandemic). Starting with the 2019 plan year (for which taxes were filed in 2020), the Minimum Essential Coverage (MEC) penalty no longer applies. Consumers who had a Marketplace health plan received Internal Revenue Services (IRS) form 1095-A from the Marketplace, which should be used to fill out IRS form 8962 on the premium tax credit. Consumers who estimated their 2020 income incorrectly when they applied for coverage during the 2019-2020 Open Enrollment Period may be subject to premium tax credit reconciliation, where the IRS re-determines how much tax credit a household should have received based on their actual 2020 income and adjusts their tax return accordingly.

Center on Budget and Policy Priorities
A tool designed to help tax preparers with different income calculations that are necessary to determine eligibility for ACA exemptions related to income, especially the affordability exemption (January 2018)
ACA Exemptions Related to Income Tool

Guide for assisters on tax rules related to Marketplace enrollment and Medicaid eligibility (updated September 2018)
The Health Care Assister’s Guide to Tax Rules

Information for tax professionals on the ACA (February 2015)
The Tax Preparer’s Guide to the Affordable Care Act

A webinar recording which reviews the affordability exemption and walks through how to calculate whether a person is eligible for the affordability exemption using TaxSlayer and the CBPP-developed ACA Exemptions Related to Income Tool (March 2017)
VITA/TCE ACA Tax Training Webinar

Centers for Medicare and Medicaid Services (CMS)
Announcement on consumer protection against health care fraud and abuse control program
Health Care Fraud Fact Sheet

Comprehensive collection of resources for assisters on how the ACA affects tax preparation for a variety of different groups
Tax Information

FAQ for consumers on appealing eligibility decisions in the Health Insurance Marketplace
English
Spanish

Flyer explaining who is eligible for an exemption from the penalty
Exemptions from the Health Insurance Marketplace Fee

Instructions to assist in the completion of an exemption application on the Health Insurance Marketplace
Bilingual instructions for Hardship, Affordability (FFM), Affordability (SBM), and Religious sect

Printable checklist of what consumers need to file taxes
My Tax Checklist

Farmworker Justice
An FAQ guide on how the ACA will affect taxes for farmworkers (March 2015)
The Affordable Care Act and Taxes: Frequently Asked Questions on How the ACA Affects Taxes for Farmworkers

Healthcare.gov
Webpage explaining the penalty for not having coverage and who is exempt from the fine
Fees and Exemptions Overview

Webpage explaining the exemptions from the requirement to have health insurance
Health Coverage Requirement Exemptions Overview

In the Loop: Tax Resources
The ACA and Tax Filing for Survivors of Domestic Violence and Married, Separated and Abandoned Spouses (updated August 2017)
Advance Premium Tax Credits (updated August 2018)
The Individual Shared Responsibility Payment and Exemptions (February 2017)
Reconciliation of Advanced Premium Tax Credits (updated March 2018)

Internal Revenue Service (IRS)
Section of the IRS website with information for both businesses and individuals and families on how the ACA will affect tax filing for 2014 and beyond
Affordable Care Act (ACA) Tax Provisions

Web-based tool to help consumers find tax filing software
Free File Software Lookup Tool

National Health Law Program
A brief describing the ACA tax filing requirements and offering tips and resources to help those receiving coverage through the Marketplace file their taxes (March 2015)
Getting Ready for April – Tax Filing Considerations

Young Invincibles
Video explaining ACA tax rules for the 2018 tax season (March 2019) 
Adulting 101 – Health Coverage & Your Taxes

TIPS AND TOOLS FOR SUCCESSFUL OUTREACH AND ENROLLMENT

Asian & Pacific Islander American Health Forum
A webinar which discusses the current state of AA&NHPI efforts supporting Open Enrollment, what AA&NHPI and immigrant communities need to know, and how enrollment assistors, providers and community organizations can ensure a successful enrollment period and monitor challenges (October 2017)
AA and NHPI Communities and Open Enrollment Webinar

Benefit Focus
Blog post explaining why and how to incorporate social media into Open Enrollment campaigns (July 2018)
Why It’s Time to Put Social Media in Your Open Enrollment Strategy

Centers for Medicare and Medicaid Services (CMS)
Reference manual for assisters utilizing the Federally-Facilitated Marketplace (January 2016)
The Assister’s Standard Operating Procedures Manual

Fact sheet that provides information and guidance Navigators and certified application counselors (collectively, assisters) need to know in order to help consumers with coronavirus disease 2019 (COVID-19)-related challenges (October 2020)
COVID-19 Fact Sheet for Assisters

CMS toolkit for agents and brokers working on the Marketplace, as well as rules for assisters working with agents and brokers (October 2015)
Resources for Agents and Brokers in the Health Insurance Marketplaces
An Assister’s Guide to Working with Agents and Brokers

Community Catalyst
Archived resources from Community Catalyst and the National Health Law Program’s discontinued In the Loop: Connecting the Enrollment Community
Resources for Enrollment Assistance

Connect for Health Colorado
Website that allows consumers to calculate Modified Adjusted Gross Income (MAGI) with or without using last year’s tax return (can be used by anyone in the country)
Calculate Modified Adjusted Gross Income

Colorado Covering Kids and Families
Information on strategies to do school-based outreach and enrollment
The ABCs of School-Based Outreach

Report showcasing promising outreach and enrollment practices in Colorado for communities wishing to begin their own outreach and enrollment program to increase access to health coverage, or to serve as an inspiration to try new outreach and enrollment approaches
Promising Practices in Outreach and Enrollment: Lessons Learned from Colorado’s Outreach and Enrollment Learning Collaborative (March 2017)

Enroll America
A guide for providers and hospitals on performing insurance outreach and education to patients (January 2016)
Provider and Hospital Week of Action Toolkit

Guide to communication strategies for the 2015-2015 open enrollment period (October 2015)
Communicators Guide for 2015-2016

Report on why some people enrolled during the first open enrollment period and some did not (May 2014)
Why Did Some People Enroll and Not Others?
Survey results from above study

Fact sheet on how to conduct phone-a-thons to do outreach and enrollment (March 2014)
Connecting with Consumers through Phone-a-Thons

Document on how in-person assistance is crucial to many people (March 2014)
In-Person Assistance Maximizes Enrollment Success

Fact sheet that covers reaching and engaging consumers (December 2013)
Outreach Planning 2.0

Simple strategies to encourage clients to enroll in new coverage options (December 2013)
Tips for Talking with Your Patients About Their New Health Coverage Options

Slideshow on the need for outreach and enrollment and some best practices, includes the four key messages for outreach and enrollment that have been shown to be most effective for 89% of the population (slide 39)
Outreach and Enrollment: New Opportunities in Health Coverage

Families USA
Issue Brief on recruiting and training volunteers to help increase capacity without increasing costs.
Using Volunteers in Navigator and Assister Programs: Doing More with Less

Healthcare.gov
If you need to change your organization’s information listed on the Find Local Help website, use the link below
Update Organization Information

Health Center Resource Clearinghouse
Resources assembled around various Outreach focus areas
Outreach Resources

Health and Human Services (HHS)
HHS Uninsured Outreach Mapping Tool is designed to help Federally Qualified Health Centers (FQHCs) improve health outcomes, address disparities, and increase access to coverage
Uninsured Outreach Mapping Tool Tutorial and FAQ
Uninsured Outreach Mapping Tool

Health Resources and Services Administration (HRSA)
HRSA runs a PCA listserv and distributes important information, including training material, via this list, if you are not yet a member of this list, please contact April Patten at apatten@hrsa.gov

In the Loop
In the Loop was an online enrollment forum with more than 2,000 members.

Information about the identity proofing process and how to help consumers
Experian ID Proofing FAQs

Michigan Primary Care Association (MPCA)
How to set up a workstation that optimizes the health insurance enrollment experience for clients
Enrollment Workstations at Your Health Center and in the Field

Slides with information on how to recognize outreach and enrollment stakeholders, designate a team with a coordinator, construct a plan, and create measures of success
The Outreach and Enrollment Playbook

Survey for consumers after an enrollment session
Outreach and Enrollment Quality Survey

National Association of Health Access Assisters (NAHAA)
Quick guide on using volunteers leading up to and during Open Enrollment to maximize O&E work.
Incorporating Volunteers into Outreach and Enrollment Work

National Conference of State Legislatures
Tips for successful consumer outreach for both Medicaid and the Marketplace, assembled post-open enrollment to reflect best practices (May 2014)
Medicaid and Marketplace Outreach and Enrollment Options for States

Out2Enroll
Training on LGBTQ cultural competency and LGBTQ-specific enrollment questions
Assister Training

Robert Wood Johnson Foundation
Report on how states are streamlining eligibility and enrollment (February 2014)
Experience from Maximizing Enrollment States in Streamlining Eligibility and Enrollment

Brief on how tax preparers are a promising source of application assistance for the uninsured (February 2014)
Tax Preparers Could Help Most Uninsured Get Covered

Report that shows differences in outreach and enrollment assistance efforts across ten states (October 2013)
Reaching and Enrolling the Uninsured: Early Efforts to Implement the Affordable Care Act

Report that shares findings and lessons learned from the foundation’s Maximizing Enrollment program’s state grantees’ experiences of adopting and piloting inventive technology strategies in four areas: 1) application and renewal simplifications; 2) customer interfaces; 3) system functioning; and 4) workflow management (July 2013)
Harnessing Technology to Streamline Enrollment: Experiences from Eight Maximizing Enrollment Grantee States

Set of progress indicators that were developed to show the progress being made in enrollment in the eight grantee states (April 2013)
Maximizing Enrollment Progress Indicators

Value Penguin
Tool that allows users to compare ACA marketplace health plans, premiums, subsidies, and benefits
Value Penguin

Wisconsin Office of the Commissioner of Insurance
Consent form for CACs to use and store personally identifiable information
Sample CAC Consent Form

POST-OPEN ENROLLMENT

American Association of Retired Persons
Information for consumers on special enrollment periods
Special Enrollment in the Health Insurance Marketplace

Center on Budget and Policy Priorities
A chart listing the various events that can trigger a Special Enrollment Period (SEP) in the Marketplace, the timing for when people can access them, and when coverage through a particular SEP becomes effective
Special Enrollment Period Reference Chart

Centers for Medicare and Medicaid Services (CMS)
Guidance on special enrollment periods for people with complex cases (March 2014)
Guidance for Issuers on Special Enrollment Periods for Complex Cases

Slides on the role of assisters after open enrollment (March 2014)
Open Enrollment and Beyond

Various resources on how to make the most of health insurance and steps to take once covered. These resources are offered in various languages including Arabic, Chinese, English, Haitian Creole, Korean, Russian, Spanish, and Vietnamese
Roadmap to Better Care

Colorado Community Health Network (CCHN)
Thorough document on what O&E staff can do post open enrollment
Outreach and Enrollment: It’s Not Over Yet!

Community Catalyst
Outreach & Enrollment tools for Special Enrollment Periods (SEPs) offered in various languages including Chinese, Korean, Marshallese, Spanish, Tagalog, Tongan, and Vietnamese. These are all contained within a publicly available Google Drive
Outreach Hub – Special Enrollment Period Resources

Healthcare.gov
Information on what consumers can do post-open enrollment (April 2014)
Open Enrollment is Over: Here are Some Options

Information on continuous Medicaid and CHIP enrollment (April 2014)
Still Open: Coverage in Medicaid and CHIP

In the Loop
Tips for assisters to help consumers resolve outstanding application inconsistencies
Tips to Resolve Application Inconsistencies

Kynect
Kynect, Kentucky’s health insurance marketplace, has developed a flyer on special enrollment periods
Special Enrollment for Health Coverage after March 31st

Take Care Utah
Information on special enrollment periods for consumers
Special Enrollment Periods

Young Invincibles
Video explaining Special Enrollment Periods (SEPs), specifically geared towards young adults (July 2019)
Adulting 101: Special Enrollment Periods

Flyer on young adults and Special Enrollment Periods (SEPs)
Young Adults More Likely to Qualify for Special Enrollment

Unbranded graphics to advertise health insurance Special Enrollment Periods (SEPs)
SEP Social Media Graphics

TOOLKITS FOR OUTREACH AND ENROLLMENT

Asian & Pacific Islander American Health Forum
Social media toolkit intended to help users get started with Open Enrollment online outreach and education. The toolkit covers basic social media “how to’s” for Facebook and Twitter and tips for social media success. Users will also find a social media timeline of Twitter and Facebook messaging for the days leading up to Open Enrollment (November 2014)
Action for Health Justice Open Enrollment Social Media Toolkit

Centers for Medicare and Medicaid Services (CMS)
Toolkit on using earned media for outreach
Marketplace Assister Earned Media and Promotion Toolkit

Toolkit on outreach to college students
ACA 101: Health Insurance Marketplace Outreach and Enrollment Toolkit for Colleges, Universities, and Community Colleges

Community Catalyst
How to enhance your organization’s storytelling and strengthen your advocacy (2017)
Our Voices have Power: A Story Banking Guide

Google Drive folder with social media graphics, fact sheets, and other materials for outreach during open enrollment. Many of the materials are customizable
Outreach Hub

Enroll America
Toolkits for doing outreach to various populations
Health Care from the Pulpit
Muslim Faith Engagement Toolkit
Young American Engagement Toolkit

From Coverage to Care
Toolkit to help consumers enroll in coverage or change their plan (September 2017)
Enrollment Toolkit: Helping Consumers Choose the Health Plan That’s Right for Them

Get America Covered
Provides proven strategies and templates for use in outreach to media and your community to raise awareness about open enrollment
OE8 Take Action Toolkit

Health Care for All
Resource guide for outreach to Latinx people
Promising Practices for Latino Outreach and Enrollment

Out2Enroll
Social media graphics and messaging for LGBTQ+ outreach
OE8 Social Media Toolkit
Open Enrollment Social Media Graphics

Young Invincibles (YI)
Resources and suggested messaging to help consumers understand their options for Open Enrollment 8
OE8 Partner Toolkit – English
Kit de Herramientas Para Inscriptión Abiertas (OE8 Partner Toolkit – Spanish)

REGION VIII PRIMARY CARE ASSOCIATION (PCA) OUTREACH AND ENROLLMENT WEBSITES

Association for Utah Community Health (AUCH)
Take Care Utah is a partnership between AUCH, Utah Health Policy Project, and Utah 2-1-1. The Take Care Utah network serves as the statewide hub for insurance enrollment information
Take Care Utah

Colorado Community Health Network (CCHN)
CCHN is Colorado’s Primary Care Association (PCA); its website has various general and Colorado-specific outreach and enrollment resources
Outreach and Enrollment

Community HealthCare Association of the Dakotas (CHAD)
CHAD is North Dakota and South Dakota’s PCA; they administer the Get Covered North Dakota and Get Covered South Dakota Initiatives, which are designed to provide state-specific information for consumers on getting enrolled in affordable coverage
Get Covered North Dakota
Get Covered South Dakota

Montana Primary Care Association (MPCA)
MTPCA runs the Cover Montana website, which will serve as a resource for assisters and community partners to coordinate and connect with one another, as well as a place for consumers to obtain information about both Marketplace and Medicaid enrollment
Cover Montana

Wyoming Primary Care Association (WYPCA)
WYPCA webpage for health centers and community members to enroll in health care coverage
Apply for Marketplace Health Insurance