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The Center for Consumer Information & Insurance Oversight

 

Consumer Assistance Program Grants: How States Are Using New Resource to Give Consumers Greater Control of Their Health Care

New Consumer Assistance Program grants will help make sure that consumers understand their rights and receive their benefits under the Affordable Care Act. Over $5 million in new resources will help grantees develop or expand programs to help consumers with health insurance questions and concerns. These new grants will help strengthen and enhance ongoing efforts in the States and local communities to protect consumers from some of the worst insurance industry practices. Below, you can find a summary of how each grantee will use its resources:

 

California

Department of Managed Health Care, in partnership with the California Department of Insurance and Office of the Patient Advocate

Amount Awarded: $442,863 (9/26/2014)

  • Partner with non-profit community-based organizations to provide direct, local consumer assistance
  • Create consumer -friendly online dashboard aimed at collecting licensed health plans data currently collected by DMHC to assist consumers with comparing and locating health plans suited for their needs. Create appropriate, accessible health care consumer information and resources for seniors and Californians with disabilities
  • Expand existing resources and training materials for consumer assistance organizations
  • Develop recommendations to standardize and improve data collection and reporting of consumer issues and  resolutions

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Connecticut

Office of the Healthcare Advocate

Amount Awarded: $442,863 (9/26/2014)

  • Expand and enhance capacity to assist consumers with eligibility and enrollment issues
  • Reach Connecticut's numerous non-English/non-Spanish speaking and disabled populations through multiple outreach platforms including partnership with a non-profit entity with a strong history of outreach and education through its large network of organizations

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District of Columbia

Amount Awarded: $442,863 (9/26/2014)

  • Expand efforts to market the services of the Consumer Assistance Program to the public, including targeting the District's Hispanic communities
  • Enhance staff knowledge and skills through training staff on changes to local laws and various aspects of the Affordable Care Act. Training will enhance the capability of staff to provide effective consumer assistance and to conduct community workshops through a new and innovative neighborhood outreach program that takes health education into non-traditional public and private locations.

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Maine

Consumers for Affordable Health Care, under contract with the State of Maine

Amount Awarded: $442,863 (9/26/2014)

  • Expand outreach and education workshops so that more information is available to consumers and service providers throughout the state
  • Strengthen referral relationships with public and private legal organizations, enhance internet outreach, and develop an innovative relationship with hospitals in order to assist consumers/patients with health insurance coverage issues
  • Enhance the online health care guide to provide easy access to information about affordable health care options and related issues, such as claims and appeals
  • Increase staffing as the demand from consumers increases

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Maryland

Office of Attorney General, Consumer Protection Division, Health Education and Advocacy Unit (HEAU)

Amount Awarded: $442,863 (9/26/2014)

  • Conduct a mass transit outreach campaign and other outreach activities to educate consumers about their rights with respect to group health plans and health insurance options and coverage, new rights under the Affordable Care Act, and the HEAU's services

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Massachusetts

Executive Office of Health and Human Services

Amount Awarded: $409,224 (9/26/2014)

  • Educate consumers about their rights with respect to group health plan and health insurance coverage
  • Enroll consumers in health care coverage of all types and payers, including assisting consumers' enrollment in existing Massachusetts programs that help pay for group health plan and health insurance premiums
  • Track and analyze data points over time to identify and address systemic barriers to access and enrollment into affordable health coverage options
  • File complaints and appeals for internal or external grievances processes, and provide independent legal assistance to consumers as they navigate the appeals process with respect to group health plans and health insurance coverage
  • Conduct a targeted, culturally and linguistically appropriate consumer health care outreach and education campaign to non- and limited-English-speaking communities through ethnic media channels
  • Build greater capacity and more accessibility through additional access points for consumers through community-based organizations

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Michigan

Office of Financial and Insurance Regulation, Consumer Services Division

Amount Awarded: $442,863 (9/26/2014)

  • Increase consumer hotline call center staff and provide staff training
  • Maintain and expand statewide consumer outreach and education activities, re-printing consumer publications as needed
  • Continue interpreter services provided on the consumer hotline
  • Host legislative outreach forums for state legislators and constituents to discuss health insurance basics, the ACA, and how to resolve consumers with health insurance concerns.
  • Monitor and evaluate success of the expansion of consumer assistance services through quantitative measured data regarding the number of consumers contacting the Consumer Assistance Program from various areas and populations of the state

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Mississippi

Department of Insurance

Amount Awarded: $440,595 (9/26/2014)

  • Expand consumer assistance program by adding an additional regional office in the Mississippi Delta Region
  • Partner with two non-profit organizations with strong ties to the Latino and Vietnamese populations, growing communities in Mississippi with unmet health needs
  • Create a “Health Insurance Consumers Guide” to serve as a handbook for newly insured consumers that will outline the appeals process and basic insurance terms
  • Partner with a third non-profit membership organization representing the interests of several local community health centers to facilitate expanded assistance to the African-American population
  • Expand staff and other resources to provide consumer assistance to these special populations

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Missouri

Department of Insurance

Amount Awarded: $442,863 (9/26/2014)

  • Assist consumers with health coverage complaints and with filing of their first and second level appeals
  • Increase staff to ensure the capacity and expertise exists to provide assistance to consumers for all health insurance complaints,  to assist with educational presentations and public relations duties,  and to ensure effective oversight of programs
  • Provide consumer education and outreach activities, assist consumers in finding and enrolling in health care plans best suited for their needs, and answer consumer inquires about health coverage options available and insurance company complaint indices

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New York

State Department of Health

Amount Awarded: $442,863 (9/26/2014)

  • Enhance the capacity of partnering with community based organizations (CBOs) to strengthen their geographical reach, provide more services, and increase helpline capacity
  • Deepen presentation skills to educate consumers
  • Ensure that staff have the capacity to evaluate the merits of consumer appeals cases and assist consumers with those appeals and grievances when appropriate
  • Strengthen technical assistance in upstate New York

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North Carolina

Department of Insurance, Health Insurance Smart NC

Amount Awarded: $442,863 (9/26/2014)

  • Increase staff serving consumers
  • Implement a statewide outreach program to reach special populations using radio, web, and print ads
  • Increase consumer education by participation in an increased number of speaking engagements, health fairs, and media events
  • Coordinate and hold train-the-trainer events across the state to educate key stakeholders on the Consumer Assistance Program and Affordable Care Act provisions
  • Produce posters and increased number of program brochures as well as informational fact sheets on health insurance provisions and changes to be distributed across the state

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Vermont

Department of Health Care Regulation, Division of Health Care Administration

Amount Awarded: $442,863 (9/26/2014)

  • Increase staff in order to expand services and better respond to the increasing number of consumers needing help with health care, health insurance issues, and assistance with filing premium tax credits
  • Expand outreach efforts to educate consumers, Navigators, enrollment assisters, and tax preparers on a wide variety of ACA issues, including premium tax credits, appeals, and health insurance options

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