Georgetown University's Center on Health Insurance Reforms (CHIR) has launched its web-based Navigator Resource Guide on Private Health Insurance and the Health Insurance Marketplaces. While designed with the needs of Navigators in mind, the Guide is a hands-on, practical resource for anyone who needs to communicate with consumers about the Affordable Care Act. With funding from the Robert Wood Johnson Foundation, the Guide includes easy-to-read background information on key health insurance and marketplace issues, and provides close to 300 web-based and searchable frequently asked questions (FAQs) reflecting a wide range of situations consumers may face as they navigate our changing health care system.

 

About the Guide

 

The Guide is organized into four sections, based on the types of circumstances in which consumers might present themselves to a Navigator: (1) People without coverage, (2) People with coverage, (3) Employers offering coverage, and (4) Post-enrollment problems with coverage. In each case, CHIR experts provide helpful background on the topic with accompanying FAQs, culled from common consumer situations. The Guide will be updated in real time to keep pace with evolving federal rules and guidance. Examples of the questions answered in the Guide include:

  • Are there exemptions to the individual mandate penalty? What are they?
  • My son goes to college in another state, but we want to enroll him in our family plan. Can we do that?
  • I own my own business and have no employees. What are my options?
  • I have 47 employees and I'm trying to decide if I should hire more. What are the implications if I have more than 50 employees?
  • I have an offer of coverage through my employer, but the premiums are too expensive. Can I get financial help to buy a marketplace plan?
  • Does pregnancy trigger a special enrollment opportunity?
  • I'm eligible for COBRA but haven't elected it yet. Does that affect my eligibility for marketplace subsidies?
  • I'm raising my grandchild and claim her as a dependent. Are we considered a household of two?
  • What are health care sharing ministries? What are the risks and benefits of signing up for one?
  • I was denied coverage for a service my doctor said I need. How can I appeal a decision?

The Guide is part of a Robert Wood Johnson-funded project that includes technical and policy support for Navigators and other in-person assisters in 6 states - Arizona, Arkansas, Florida, Georgia, Michigan and Ohio - to help them answer their toughest questions from consumers seeking to enroll in coverage. CHIR is grateful for the support and collaboration of experts from Georgetown University's Center for Children and Families, the Center on Budget and Policy Priorities, and the Kaiser Family Foundation in the development of the FAQs included in the Guide.