1. health and fitness

April 2015 Coalition Update
CKF News
New CKF Blog Post: Understanding SEPs and
Qualifying Life Change Events
O&E Resource Guide Now on CKF Website
Health Policy
EEMAP Vendor Responsibilities Shifting to
Counties and Denver Health
Parent and Caretaker Relative Eligibility
Change FAQ Now Available
Remaining Non-ACA Compliant Health
Insurance Plans Will End in 2015
MSB Recruiting New Member
Resources
New Webinar and Fact Sheets about Taxes
and Insurance for People with DACA
Connect for Health Colorado Report on
Second Open Enrollment Period Released
Apply Now for School Health Professional
Grant
Upcoming Calls, Trainings, and Events
CBMS Support Call for Community Partners
and Counties
Kids Health Convening
DHS Offers Navigator Training
Outreach and Enrollment
Important SES Updates from Connect for
Health Colorado
PEAKHealth App Available for Medicaid and
CHP+ Clients to Manage Benefits
New CMS Resource Available: Coverage to
Care Enrollment Toolkit
CKF News
Agency Partners Work Group
April 24, 2015, from 9:00 – 10:30 a.m.
CCHN (600 Grant St., Ste. 800, Denver)
March 2015 Meeting Notes
March 2015 Meeting Recording
Health Policy Work Group
June 18, 2015, from 9:00 – 10:00 a.m.
CCHN (600 Grant St., Ste. 800, Denver)
February 2015 Meeting Notes
 CKF fact sheet
 Guide to CKF meetings and work
groups
 CKF meeting and event calendar
 Contact Liz Tansey with questions
Denver Outreach Partners
May 12, 2015, from 9:00 – 10:30 a.m.
CCHN (600 Grant St., Ste. 800, Denver)
April 2015 Meeting Notes
CKF Coalition
July 8, 2015, from 9:00 – 10:30 a.m.
CCHN (600 Grant St., Ste. 800, Denver)
April 2015 Meeting Notes
April 2015 Meeting Recording
New CKF Blog Post: Understanding SEPs and Qualifying Life Change Events
CKF’s newest blog post will help you understand how Special Enrollment Periods (SEPs) work,
when they apply, how consumers can qualify for a SEP, and how long consumers have to shop
or make a change to an existing plan after a Qualifying Life Change Event. The post also lists
the Qualifying Life Change Events that allow consumers to shop for new coverage, or make
changes to their existing coverage.
O&E Resource Guide Now on CKF Website
The CKF website now features an Outreach and Enrollment (O&E) Resource Guide, which
includes a selection of some of the best O&E presentations and webinars, consumer education
resources, interactive tools, job aids, and background information. To suggest a resource, topic,
or to provide general feedback, contact Sitora Rashidova at [email protected].
Health Policy
EEMAP Vendor Responsibilities Shifting to Counties and Denver Health
The Colorado Department of Health Care Policy and Financing (HCPF) is transitioning the
Eligibility and Enrollment Medical Assistance Program (EEMAP) contract duties currently
performed by the vendor MAXIMUS to county departments of human/social services and
Denver Health’s new office of Medical Assistance Program Services (MAP). The MAXIMUS
contract will end on June 30, 2015.
The Denver Health MAP office will also take on other duties currently being handled by HCPF’s
back office contract, including phone application assistance, Department of Corrections (DOC)
application processing, and cases for families that have both Medicaid/Child Health Plan Plus
(CHP+) and Advanced Premium Tax Credit (APTC) eligibility. HCPF’s back office contract will
end on April 30, 2015.
The transition of the MAXIMUS and back office workloads will occur in two phases, to be
completed by June 30, 2015:
Phase 1, beginning May 1, 2015
 Denver Health will begin taking phone applications, processing DOC applications, and
performing escalated case research and resolutions.
Phase 2, beginning May 22, 2015
 Counties will begin to receive medical-only cases submitted through the Program
Eligibility and Application Kit (PEAK) instead of these cases going to MAXIMUS.
Counties will continue to be assigned combo cases (e.g. Medical Assistance and Food
Assistance), non-Modified Adjusted Gross Income (MAGI) cases, ongoing case
maintenance, renewals, and quality assurance/quality control.
 Denver Health will begin to take on the CHP+ call center, fee and premium
administration for CHP+ and Medicaid Buy-in programs, manual enrollment tasks,
disenrollment tasks, and CHP+ appeals and grievances.
Although more information is forthcoming, HCPF presented these changes at the April 3, 2015,
All Kids Covered Initiative meeting. For more information, please read the notes and review the
slides from the presentation. HCPF is developing a high-level summary of the transition that will
be sent to counties, providers, and other stakeholders soon. CKF will share that document with
the coalition as soon as it is available. Additionally, we will be discussing these changes at the
April 24 Agency Partners Work Group meeting.
Parent and Caretaker Relative Eligibility Change FAQ Now Available
Beginning April 1, 2015, the income eligibility level for the Parent and Caretaker Relative MAGI
Medicaid category was lowered from 107 percent of the Federal Poverty Level (FPL) to 68
percent FPL. Through a mass update in the Colorado Benefits Management System (CBMS),
most parents and caretaker relatives who were enrolled in this category were administratively
Colorado Covering Kids and Families (CKF) Coalition Update
Page 2
April 2015
moved to the Adult MAGI Medicaid category (the category for adults ages 19 to 64 with FPLs up
to 133 percent FPL). Parents and caretaker relatives with Medicare are not eligible for the Adult
MAGI Medicaid category, but will likely be eligible for the Medicare Savings Program (MSP). A
small number of people may not be eligible for MSP, but they will be eligible to apply for private
insurance through a SEP through Connect for Health Colorado. HCPF created a
Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (FAQ)
document about this eligibility change.
Remaining Non-ACA Compliant Health Insurance Plans Will End in 2015
The Colorado Division of Insurance (DOI) announced that all health insurance plans for
individuals and small employers that do not meet Affordable Care Act (ACA) requirements will
not continue into 2016 (note: this decision does not impact grandfathered plans, defined by the
ACA as plans with an effective date prior to March 23, 2010). This means that insurance
companies will not continue to offer these plans and consumers will not be able to renew these
plans. For 2016, individuals and small employers that are not enrolled in grandfathered plans
must enroll in ACA-compliant plans in order to receive coverage. Based on a survey of health
insurance carriers the DOI conducted earlier this year and reflective of enrollment as of Dec. 31,
2014, 189,779 people will have their non-ACA compliant individual or small group plans
discontinued by the end of 2015, and will have to choose a new ACA-compliant plan for 2016.
Insurance companies will notify all of their individuals and small employers who hold non-ACA
compliant plans of the discontinuation. These notices must contain information about all
available options; whether or not the company will offer plans that meet ACA requirements;
finding ACA-compliant plans offered through Connect for Health Colorado; and the ability to
purchase plans from other insurance companies. Additional information, including FAQs, can be
found on Colorado.gov/health or by contacting the DOI Consumer Affairs at 303-894-7490 / 1800-930-3745 (outside the Denver metro area) or email questions to
[email protected].
MSB Recruiting New Member
The Medical Services Board (MSB) adopts the rules that govern HCPF programs. The board
consists of 11 members who are appointed by the Governor and confirmed by the Senate. The
board is currently seeking applications for a vacant position and is looking to expand its pool of
applicants for consideration. Coloradans who meet the general requirements outlined below are
strongly encouraged to submit an application through the Governor’s Office of Board and
Commissions. All applications are kept on file in the Governor’s Office for two years from the
date of submission. Pursuant to §§25.5-1-301 through 25.5-1-303, C.R.S. general requirements
for board membership include:
 Board members must have knowledge of Medical Assistance programs;
 Board members may include a person or persons who have received services through
programs administered by HCPF;
 No more than six members can be of the same political party;
 At least one member shall be appointed from each congressional district;
 Membership shall include representation by at least one member who is a person with a
disability, a family member of a person with a disability, or a member of an advocacy
group for persons with disabilities, provided that the other requirements are met.
Board members do not receive compensation for their service but are reimbursed for
reasonable and necessary actual expenses incurred in the performance of their official duties.
Board meetings occur on the second Friday of each month and begin at 9:00 a.m. The duration
Colorado Covering Kids and Families (CKF) Coalition Update
Page 3
April 2015
of meetings varies based on the number of rules, length of presentations, length of discussion,
public testimony, and other factors. On average most meetings last until around noon. Meeting
materials are made available to members one week prior to the meeting and it is expected that
members will devote sufficient time to reviewing this information and that every effort will be
made to attend meetings. General information, current member information, past meeting
agendas, draft rules, and meeting recordings and presentations are accessible on the MSB web
page.
Outreach and Enrollment
Important SES Updates from Connect for Health Colorado
Health Coverage Guides and Certified Application Counselors can now help customers through
the marketplace financial assistance application process, the Shared Eligibility System (SES),
for APTC and Cost-Sharing Reduction eligibility determinations. However, please note that
unless the reason for enrolling outside of open enrollment is moving to Colorado, it is not likely
the application will come to Connect for Health Colorado cleanly after clicking “shop,” and the
customer will need to record the authorization number, case number, and contact the Connect
for Health Colorado customer service center where a reprocessing tool will be used to
ensure the application is being processed correctly and allow the customer to continue
shopping.
 This screenshot shows the post-open enrollment overview screen. New customers click
“Get 2015 Coverage” to start the application. Current customers click “Update Eligibility”
to return to the SES. If the applicant had not previously submitted a complete SES
application they should complete all screens.
 It is important that the financial application is completed thoroughly before it is submitted.
If the application has missing or incorrect information it will take the familiar long process
to correct the application.
 Individuals who indicate that they are not a tax filer will not receive an APTC
determination. In order to receive APTCs, applicants must intend to file taxes. People
who are not required to file taxes can still choose to file if they would like to receive the
APTC.
PEAKHealth App Available for Medicaid and CHP+ Clients to Manage Benefits
PEAKHealth is a new mobile app from HCPF for Apple and Android devices which allows
current Medicaid and CHP+ clients to manage their accounts. The app can be used by clients to
search for a doctor, dentist, or pharmacy; update contact information, remove a member of the
household, and upload paystubs; view CHP+ and Medicaid Buy-in account balances; and
provides an electronic medical card for provider visits. The app cannot be used to apply for
benefits. More information about the PEAKHealth app, including FAQs and a video of the app in
action, is available here.
New CMS Resource Available: Coverage to Care Enrollment Toolkit
The Centers for Medicare & Medicaid Services (CMS) published an Enrollment Toolkit as part of
the Coverage to Care initiative. The toolkit is a comprehensive resource intended to help
assistors walk through health coverage options with their clients.
Colorado Covering Kids and Families (CKF) Coalition Update
Page 4
April 2015
Resources
New Webinar and Fact Sheets about Taxes and Insurance for People with DACA
A recorded webinar is now available on taxes from the National Immigration Law Center (NILC)
and United We Dream (UWD) for immigrants with Deferred Action for Childhood Arrivals
(DACA) status. The webinar addresses confusion about taxes and health coverage for this
population, including the steps they should take to avoid being assessed the tax penalty if they
did not have health insurance during the year. Two fact sheets are also available:
 UWD: Taxes & DACA: What do I need to know?
 NILC: DACAmented and Undocumented Immigrants and the Obamacare Tax Penalty
Connect for Health Colorado Report on Second Open Enrollment Period Released
Connect for Health Colorado released a new report, By the Numbers: Colorado’s Second Open
Enrollment. The second open enrollment period outpaced the first open enrollment period even
though it was shorter by 100 days. By Feb. 28, 2015, 141,639 Coloradans enrolled in 2015
coverage, a level that is 10 percent more than the first open enrollment period. More information
can be found in the report.
Apply Now for School Health Professional Grant
The School Health Professional Grant Program is now available from the Colorado Department
of Education. The grant program is designed to provide funds to eligible education providers to
enhance the presence of school health professionals (e.g. school nurses, school psychologists,
school social workers, and school counselors) in secondary schools serving grades seven
through 12. Applications are due on May 7, 2015.
Upcoming Calls, Trainings, and Events
CBMS Support Call for Community Partners and Counties
On April 23, 2015, there will be a minor build in CBMS to fix help desk tickets. These fixes
should make it easier for CBMS users to process cases more quickly and accurately. The
Governor’s Office of Information Technology is hosting support calls for counties and community
partners following the build. The conference line and passcode for all calls is: 1-877-820-7831,
passcode: 349141#.
 April build knowledge transfer call for counties
April 16, 2015, from 12:00 to 1:00 p.m.
 Post-build call for counties
April 24, 2015, from 12:00 to 1:00 p.m.
 Post-build follow-up call for counties
April 30, 2015, from 12:00 to 1:00 p.m.
 Post-build follow-up call for community partners
April 30, 2015, from 3:00 to 3:45 p.m.
Kids Health Convening
Join Aurora Health Access, Children’s Hospital Colorado, Colorado Children’s Healthcare
Access Program, Tri County Health Department, and the Colorado School of Public Health for a
Kids Health Convening on May 11, 2015, from 9:00 a.m. to 12:00 p.m. at Children’s Hospital
Colorado (13123 East 16th Ave., Mt. Princeton Room, 2nd Floor, Aurora, CO). Contact Ellen
Steiner with questions ([email protected]) and register here.
Colorado Covering Kids and Families (CKF) Coalition Update
Page 5
April 2015
DHS Offers Navigator Training
Denver Human Services (DHS) is offering a navigator training for community partners. The
navigator training includes an overview of the programs DHS offers, including food assistance,
basic eligibility for Medicaid and cash programs, energy assistance, child support, childcare
assistance program, PEAK, and a brief overview of the ACA. For more information and to
register, please contact Kathy Crusan-Ford, Agency Trainer for SNAP Into Health, at
[email protected]. The upcoming trainings will be held:
 May 22, 2015, from 9:00 a.m. to 12:00 p.m.
1200 Federal Blvd., Denver
 June 26, 2015, from 9:00 a.m. to 12:00 p.m.
1200 Federal Blvd., Denver
Colorado Covering Kids and Families (CKF) Coalition Update
Page 6
April 2015