Outreach & Enrollment Information for Assisters

Outreach and Enrollment Frequently Asked Questions (FAQ) Update – BPHC has provided clarification for health centers that are considering working with agents or brokers to further enhance the health center’s Outreach and Enrollment efforts. For more information, see FAQs 13 and 14.

What are HRSA’s ongoing expectations for health centers’ O/E activities and use of funds?

HRSA expects health centers that receive O/E funding to conduct in reach, outreach, and enrollment  assistance throughout the year, with the understanding that during the open enrollment periods, health centers will likely have to adjust resources in order to meet the increased health center patient and service area needs during open enrollment periods to maintain a similar level of effort consistent with that which was supported by initial O/E supplemental funding.

Ongoing activities supported by O/E funding may include the following:

  • Conducting in reach to uninsured eligible health center patients;
  • Conducting outreach in the health center’s approved service area, including promoting the health center as a resource for enrollment assistance;
  • One-on-one or otherwise customizable education sessions about affordable insurance coverage options;
  • Securing access to Medicaid, CHIP and other available health, social service, pharmacy and other assistance programs;
  • Assisting individuals with filing appeals and exemptions;
  • Assisting individuals with requesting a special enrollment period;
  • Assisting individuals with Medicaid, CHIP or Marketplace plan re-enrollment/renewals;
  • Assisting newly insured individuals with understanding and utilizing their insurance;
  • Ensuring that the health center is appropriately designated as an assister entity and is otherwise in compliance with all applicable federal and state laws and other requirements;
  • Maintaining a sufficient and competent assister workforce, including:
    o Ensuring that health center assisters have met all applicable federal and state training and related requirements;
    o Providing or supporting participation in other training and related professional
  • Planning and maintaining partnerships to maximize the impact of the health center in reaching uninsured eligible populations; and
  • Identifying and incorporating lessons learned to improve the enrollment process for consumers and assisters and to more effectively target outreach to uninsured eligible populations.

Quarterly Progress Report Guidance
QPR Frequently Asked Questions – updated 10/8/2014
FY 2015 Quarterly Reporting Presentation– updated 10/8/2014
Quick Reference Guide for Quarterly Reporting in EHB
Sample Quarterly Reporting Form – updated 9/24/2014

Other Resources
Families USA O&E Resources
Health Insurance Marketplace Plan Comparison Tools