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Assister Training Curriculum

Covered California published the following Assister Training Curriculum recently (Feb. 2013). The training will be delivered in a 2-3 day instructor-led or computer based training course available at various locations throughout California. Upon successful completion of the initial training course and testing, Assisters will be certified and receive a unique Assister Number which will allow Assisters to help consumers apply for coverage.

Affordable Care Act (ACA)

  • ACA Fundamentals
  • Essential Benefits
  • Covered California Overview
  • Introduction to subsidies and non-subsidies available in Covered California
  • Covered California (new marketplace) for health coverage

Assister Role

  • Assisters Program Overview, Guidelines and Responsibilities
  • Monitoring Reporting and Evaluation Procedures
  • Compensation for Enrollment
  • Covered California Marketing and Outreach Program Overview
  • Training, Technical Assistance and Help Desk Resources

Uninsured Demographics

  • California’s uninsured/underserved:
  • Basic demographics
  • Cultural and linguistic needs
  • Motivations and challenges
  • Implications for education, outreach, and enrollment support
  • Access standards for individuals with disabilities

Compliance Standards

  • Code of Conduct and Ethics
  • Conflict of Interest
  • Fraud, waste and abuse
  • Privacy and Security Standards

Handling Personal Health Information (PHI)

  • Identifying and recognizing PHI
  • HIPAA and confidentiality requirements
  • Proper handling of financial and tax information

Eligibility

  • Understanding open enrollment
  • Program overview and eligibility for Medi-Cal programs and Covered California products
  • Subsidy requirements
  • Advance premium tax credits
  • Cost sharing reductions
  • Monthly premiums
  • Native American/Alaska Native Special Populations
  • Non-subsidy requirements
  • Verification process
  • Annual re-determination process
  • Special enrollment
  • Appeals process
  • Information about Consumer Assistance Programs

Plan Options

  • Fundamentals of health insurance
  • How to choose and compare plans
  • Determining the best fit for the family
  • Medi-Cal Program, plans and cost sharing
  • Covered California subsidized and non-subsidized plan overview and benefits

Enrollment Support

  • Enrollment process overview
  • Completing the enrollment form
  • How to select a provider
  • CalHEERS program overview

Post Enrollment

  • Renewal and dis-enrollment
  • Understanding Important documents
  • Exploring other services offered
  • Consumer support

Program System Training (CalHEERS)

  • Assisting consumers apply online
  • Account maintenance
  • Process client application
  • Assister payment information
  • How to access and view reports

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