By CRAIG FREILICH
Signing up for health care insurance under the Affordable Care Act – “Obamacare” – begins this fall, but St. Lawrence County residents will have help getting through the new potentially arduous and confusing process.
With $800,000 in funding from the state Department of Health’s Health Benefit Exchange, the non-profit St. Lawrence Health Initiative is hiring and training two “navigators” to inform people, community organizations, employers and employees about the ins and outs of deciding which qualified health plans and premium assistance programs will best suit them.
Sorting through it all is not expected to be easy, which is why Health Initiative Executive Director Ruth Fishbeck applied for and was granted $160,000 a year for five years to run the navigators program.
“First and foremost, a lot of people are not aware of what’s required under quite a variety of plans through the Health Benefits Exchange,” she said. That is why the two navigators will be traveling around the county, including on nights and weekends, to advise individuals and businesses about the process and the available options.
The state Department of Health grant is requiring three full days of training for the navigators, who will be hired based in part on their experience and responsibility in related fields. The navigators will have had some online assignments before their formal training begins, and once that’s done, they will have to take and pass a test “before they’re cleared as navigators,” Fishbeck said.
The navigators’ presentations will begins soon, and the real work, for them and for those shopping for insurance, begins in October when the “exchange” opens and choosing plans begins.
The ACA requires navigators to educate the public with fair and impartial information about health plans, premium tax credits, and cost-sharing reduction payments, and to facilitate enrollment in qualified health plans.
The Health Initiative staff will work one-on-one with people applying for health insurance for the first time and at annual renewal time; explain the variety of insurance programs available through the exchange; help with private and public health insurance programs, advance premium tax credits and cost-sharing reductions; and help those with grievances, complaints or questions about health coverage find resolution with other agencies.
“That’s why we’ll have a lot of education to do,” Fishbeck said. They are waiting for materials from the state with details of the processes involved.
“We’ll be getting staff hired and trained and prepared to answer questions accurately, so we would prefer it if people don’t call us with questions yet. First, we want to get the most current and accurate information. The only thing worse than no information is the wrong information,” Fishbeck said.
She said particular attention will be paid “to the work with small businesses because they have a different ‘portal,’ the Shop Exchange, for companies with 50 employees or fewer.”
“We want to be sure that all areas in St. Lawrence County have access to in-person enrollment assistance,” said the Health Initiative’s Anne Marie Snell, who will be administering the navigators program in St. Lawrence County. “Therefore, our navigators will be on the road across the county during the day, evening, and on Saturdays,” Snell said.
A full schedule of presentations will be posted at the Initiative’s website, www.gethealthyslc.org, and at the website of the New York Health Benefit Exchange, www.healthbenefitexchange.ny.gov. The Initiative will begin scheduling appointments for in-person assistance with enrollment on Sept. 15.
There will be more information on their website in September, Fishbeck said, and people will be able to make appointments online or by phone.
Presentations to groups can be arranged by contacting Snell at 261-4760, ext. 222, or firstname.lastname@example.org.