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Spotlight

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CMS Division of Tribal Affairs 

Important Information for our Tribal partners 

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CMS Tribal Affairs Webinar

Tribal Premium Sponsorship under the Affordable Care Act

Tuesday, August 26, 2014

Time: 2:00 – 3:30 pm (ET)

Call-in Number:

(855)-897-8197

Webinar link:

http://www.cmsitutrainings.net/

The Centers for Medicare & Medicaid Services (CMS), Division of Tribal Affairs will host a webinar on Tribal Premium Sponsorship on Tuesday, August 26, 2014 from 2:00 – 3:30 pm, ET.

Tribal Premium Sponsorship is an option under the Affordable Care Act that allows Tribes, Tribal organizations and Urban Indian organizations to pay for, or “sponsor”, health insurance premiums on behalf of their tribal members. The premiums are paid to Qualified Health Plans under the Marketplace. Sponsorship is one of several options tribes may consider to improve access to health coverage for their tribal members.

Our presenter, Ed Fox, Health Services Director, Port Gamble S'Klallam Tribe will cover the following topics:

  • What Entities Can Sponsor?
  • What is QHP Premium Sponsorship?
  • Tribal, Urban and Indian Organization sponsorship
  • Sponsor Representatives
  • Initial Payment Process
  • Recurring Payment Process
  • Sponsorship Timeline

Healthcare.gov/tribal

A new question and answer (Q&A) regarding the Special Enrollment Period for American Indian and Alaska Native families has been posted on healthcare.gov/tribal

The Q&A explains that for those families that apply through the Federal-facilitated Marketplace, if one family member on the application is eligible for the Special Enrollment Period (SEP), all family members who apply on the same Marketplace application would be eligible for the SEP if otherwise eligible to enroll in a QHP.  The Q&A explains that for those who enroll in a state based marketplace, you will need to contact your state regarding whether this policy applies. 

To read the Q&A, please visit healthcare.gov/tribal or

https://www.healthcare.gov/if-im-an-american-indian-or-alaska-native-what-do-i-need-to-know-about-the-marketplace/#question=tribal-member-mixed-family

Navigator Grants  

CMS Announces Opportunity to Apply for Navigator Grants in Federally-facilitated and State Partnership Marketplaces
“Navigator” program will continue to help consumers understand health coverage options as they enroll in coverage


The Centers for Medicare & Medicaid Services (CMS) today announced the availability of funding, totaling $60 million, to support Navigators in Federally-facilitated and State Partnership Marketplaces in 2014-2015. Navigators provide unbiased information to consumers about health insurance, the Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program.

“Navigators have been an important resource for the millions of Americans who enrolled in coverage in 2014.  This funding ensures this work will continue next year, including during the open enrollment period for the Marketplaces,” said CMS Administrator Marilyn Tavenner.

The funding opportunity announcement is open to eligible individuals, as well as private and public entities, applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace.  It is open to new and returning Navigator applicants, and applications are due by July 10, 2014.

Last month, CMS finalized regulations that update the requirements applicable to Navigators. To access the final rule, visit:  https://www.federalregister.gov/articles/2014/05/27/2014-11657/patient-protection-and-affordable-care-act-exchange-and-insurance-market-standards-for-2015-and 

Navigators will now be required to maintain a physical presence in the Marketplace service area, so that face-to-face assistance can be provided to consumers. Navigator grant applicants will also be encouraged to perform background checks for all Navigator staff that will be handling sensitive or personally identifiable information (PII).  In addition to quarterly and annual reporting, Navigators will be required to submit to CMS weekly and monthly progress reports detailing their progress and activities in their target communities.

To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.332

For more information about Navigators, visit: http://cciio.cms.gov/programs/exchanges/assistance.html