Transcript Document

WELCOME
Welcome to Covered California!
Your organization’s Certified Enrollment Entity
(CEE) application identified you as the
Primary Contact.
This presentation will help you get oriented
and provide you with tools to assist you in this
role.
2
TOPICS COVERED
Chapter
Topic
1
Primary Contact Role
2
Systems and Their Use
3
CEE Certification and Training
4
Creating your CEE CoveredCA.com Account
5
Building Your Enrollment Counselor
6
CEC Training- Learning Management System
7
Tracking Your CEC’s Certification and Training
8
CoveredCA.com Accounts for CECs
9
Badges
10
Using the CEE and CEC Dashboards in CoveredCA.com
11
CEE Reimbursement
12
Recap of Resources
3
CHAPTER 1:
PRIMARY CONTACT ROLE
PRIMARY CONTACT ROLE
As the Primary Contact for the In-Person
Assistance Program, you will be the main point of
contact between Covered California and your
organization related to:
• The certification process for your counselors
• Managing information for your organization and affiliated
counselors in our online system
• Consumer enrollment activities
• Program compensation
• Keeping your Certified Enrollment Counselors (CECs)
informed of program tools, resources and updates
5
Primary Contact Role
Important aspects of your role:
•
•
•
•
•
•
•
•
Interact with all CECs to collect, enter, and upload all their information into
the online system (known as IPAS)
Complete the CEE Management Training
Create account to view your entity’s CoveredCA.com dashboard and
manage counselor enrollments
Participate in bi-weekly webinars
Disseminate program information to your CECs
Keep ALL information up to date in IPAS
Ensure adherence to program policies
The more counselors affiliated with your organization, the more
involved the primary contact role will be
6
Primary Contact Role
Receiving Program Updates from Covered California
•
To help manage of important program communications, Covered California
uses a third party email distribution system known as Sendgrid.
•
Because of spam filtering and email blocking, emails sent from systems
such as Sendgrid are occasionally flagged as spam by some receiving email
system.
•
If your entity has a strict firewall policy, you and your CECs may not receive
email communications from Covered California.
**IMPORTANT: Aside from program updates and news, Covered California
also uses Sendgrid to email important information needed to complete
certification requirements for you and your CECs, such as, your CEE
Management Training, CEE verification token to create your account with
Covered California, CEC certification training, and CEC delegation code to
create their account with Covered California.
7
Primary Contact Role
Steps to Ensure Email Delivery sent via Sendgrid:
To ensure the successful delivery of all email communications
from Covered California, we suggest the following information is
shared with your IT Department for further action.
1. White list the following:
– Sendgrid IP address: 198.37.153.60
– Email domain: @ccgrantsandassisters.org
2. Open the following ports on your email server:
– 25, 2525, 587 and 465
– Recommend opening ports 25 and 587 initially
8
Primary Contact Role
If you would like to submit any updates or
changes to your CEE’s Primary Contact
role, please complete a Change Request
Form and upload it to “My Files” in IPAS.
** Use the following document to access the Change Request Form:
** Use the following document for instruction on how to use the “My
Files” feature in IPAS:
9
CHAPTER 2:
SYSTEMS AND THEIR USE
Systems and Their Use
There are four (4) systems that CEEs should become
familiar with.
These systems include:
•
•
•
•
In-Person Administrative System (IPAS)
CoveredCA.com (CalHEERS)
Covered California Print Store
Learning Management System (LMS)
11
Systems and Their Use
In-Person Administrative System (IPAS)
• IPAS allows organizations to register online as an interested enrollment
entity.
• IPAS provides a means for CEE to register individuals interested in
becoming a CEC.
• IPAS is used to manage information relative to the CEE, such as: entity
contacts, enrollment site information, and changes in their counselor
roster.
• IPAS houses the CEE Status Board, which allows CEEs to track the
certification progress of all individuals in their counselor roster. To view
your CEE Status Board, simply login to your IPAS account and click on
the speedometer icon, as follows:
12
Systems and Their Use
In-Person Administrative
System (IPAS)
• The IPAS homepage also
houses additional information
and resources for CEEs and
their affiliated CECs.
**Make sure you frequent this
page as new information is
uploaded to the IPAS
homepage regularly.
• The direct link to the IPAS
homepage is:
https://ipas.ccgrantsandassiste
rs.org/
13
Systems and Their Use
CoveredCA.com, also known as the California Healthcare Eligibility,
Enrollment, and Retention System (CalHEERS)
•
•
•
•
This system is an online
portal that allows individuals
and small businesses to sign
up for health care coverage
through Covered California or
Medi-Cal.
The CECs affiliated with your
CEE will use this system to
enroll consumers in Covered
California health plans.
CEEs will use this system to
monitor CEC enrollment
activities
The direct link to this site is:
http://www.coveredca.com/
14
Systems and Their Use
Covered California Print Shop
Covered California provides printed and other collateral materials available for
purchase through: http://360.kpcorp.com/coveredca/Login.aspx
•
Once a CEE becomes Active on
CoveredCA.com, the PC (or IPAS
user) will receive Print Store
credentials from Covered California.
–
•
A CEE is considered Active once their
IPAS application is approved, the PC
completes the CEE Management Training,
and there is at least 1(one) active CEC on
their roster.
CEEs are allotted a quarterly budget
to purchase collateral material based
on funding availability. Amounts
allotted to each CEE can be found
online by logging in to their CEE
Print Shop account.
15
Systems and Their Use
Print Shop Resources
Link to webinar on how to attain marketing material for Covered California and the
programs available:
https://attendee.gotowebinar.com/recording/7153602224175612930
Questions related to the Print Shop should be directed to:
[email protected]
For Print Shop User ID/Login assistance e-mail:
[email protected]
16
Systems and Their Use
Learning Management System (LMS)
This system is an online training site used to administer and track CEC’s training and
examination progress. The LMS can be accessed at: https://learning.coveredca.gov
•
•
•
All individuals in your CEE’s
counselor roster must complete
their certification training and
pass an exam via the LMS as
part of their certification process.
As the Primary Contact you will
not have access to this system,
but it is important that you
understand its purpose to help
you better manage your CEC’s
certification progress.
Questions regarding LMS
should be directed to
[email protected]
17
Systems and Their Use
Internet Browsers
• If you experience difficulties with any of the systems mentioned
previously, try clearing your browser history and logging back into the
system
** For instructions on how to clear your browser history, click on the following document
• If that doesn’t work, try switching to a different browser
– Mozilla Firefox
– Chrome
– Internet Explorer
** Note: Avoid using Internet Explorer when accessing the
Learning Management System (LMS)
18
CHAPTER 3:
CEE CERTIFICATION AND TRAINING
CEE CERTIFICATION PROCESS
• Within 2-3 days after application approval, the Primary
Contact will receive an email with a link to complete
the CEE Management Training online.
• The Primary Contact is required to complete the CEE
Management Training as part of their registration
process.
• Upon completion of the CEE Management Training,
the PC must upload the CEE Management Training
Completion Form to their “My Files” in IPAS.
20
CEE CERTIFICATION PROCESS
• If you have not received the email regarding the CEE
management training, please contact the IPA Program
Support at: [email protected]
• The CEE Management Training and the CEE
Management Training Completion Form can also be found
on the IPAS homepage or by clicking on the following
links:
– CEE Management Training:
http://hbexmail.blob.core.windows.net/eap/CEE%20Management%20Training/Certified
%20Enrollment%20Entity%20Management%20Training/presentation.html
– CEE Management Training Completion Form:
http://hbexmail.blob.core.windows.net/eap/CEE%20Management%20Training%20Co
mpletion%20Form%20v5_FINAL_7.29.14.pdf
21
CEE CERTIFICATION PROCESS
ONCE THE PRIMARY CONTACT COMPLETES THE
CEE MANAGEMENT TRAINING:
• The CEE will be provided with their 10 digit entity ID
number (also known as your CEE certification number)
• The CEE will receive an email with login information for
CoveredCA.com (also known as your verification token) to
help you set up your CoveredCA.com account, used to
track your counselor’s enrollment activity.
22
CHAPTER 4:
Creating your CEE
CoveredCA.com Account
CEE COVEREDCA.COM ACCOUNT
• An email from [email protected] with subject:
“Your Certified Enrollment Entity CoveredCA.com login credentials” will
be sent to the email address used when the IPAS application was
created (also known as the User Email).
• The Primary Contact will receive a notification letting them know that
this email was sent.
• Expect to receive this email within 3-5 business days after your entity
has been set to “Active.”
A CEE is set to “Active” once both of the following requirements are met:
1. The Primary Contact has completed the CEE Management Training
AND uploaded the CEE Management Completion Form to their “My
Files” in IPAS
2. The CEE has at least one fully CEC
24
CEE COVEREDCA.COM ACCOUNT
•
This email will contain your verification token (an 8character key) and a link to access your
CoveredCA.com credentials to help you set up your
account.
•
If your verification token email does not arrive in the
allotted time OR you are not the person that created
your CEE’s IPAS account, please contact
[email protected].
** Use the following guide for instructions on how to set up your
CoveredCA.com account once you’ve received your verification token
email.
25
CEE COVEREDCA.COM ACCOUNT
Resending the Verification Token
•
If you are unable to locate the Verification Token email or accidentally deleted it, the
IPAS account holder can log into IPAS and resend the email to the user on file.
**The system will auto-generate and send the Verification Token email to the user email address on file (email used
to create the IPAS application). If you are not the person who originally created the IPAS application, check with the
individual who created the application and have them forward that email to you. If you would like to update user
information, you must login to IPAS and update this information.
** Use the following guide for instructions
on how to resend your verification token email.
•
•
** Use the following guide for instructions
on how to update the user email in IPAS.
Please remember that because this email is auto-generated and sent via a third party
system called Sendgrid, your entity’s firewall may be blocking the delivery of this
email.
Please check your spam/junk folder and confirm you did not receive the email prior to
inquiring further assistance.
**Click here for more information on how to ensure you and your CECs are receiving all email communication
from Covered California, including those sent via Sendgrid.
26
CHAPTER 5:
Building Your Enrollment
Counselor Roster
ENROLLMENT COUNSELOR ROSTER
• Your enrollment counselor roster is located in your IPAS account
and houses all your active CECs and all your prospective CECs.
• You can begin building your counselor roster in parallel with your
CEE’s training.
• Counselor candidates can be added to your application by
clicking the ‘Add Certified Enrollment Counselor’ link in IPAS.
Never attempt to add individuals to your CalHEERS profile.
Use the following guide for instructions on how to add counselors to
your roster:
28
ENROLLMENT COUNSELOR ROSTER
•
There are two forms that prospect counselors must complete to begin the
background check process include: the “Request for Live Scan Form” and the
“Criminal Disclosure Form”.
•
These forms are only available in IPAS. The primary contact MUST download
them by following these steps:
1.
2.
3.
4.
Log into IPAS
Click Entity Application
Click Certified Enrollment Counselors
Click Download Forms *
• The “Download Forms” link will become available ONLY when the status next to the CEC’s name reads “Complete.” A “Complete” status is
triggered when all application fields are complete AND a CEC Agreement is uploaded to the counselor’s profile.
IMPORTANT: These forms are personalized and should be downloaded separately for each individual. DO NOT share forms between
individuals. Pre-populated forms are required to complete the background check.
•
The prospect counselor MUST be provided with:
– Two (2) copies of the pre-populated “Request for Live Scan Form” and
– One (1) copy of the pre-populated “Criminal Disclosure Form”.
IMPORTANT: The individual applying to become a Certified Enrollment Counselor MUST complete the Criminal Disclosure form and fax it
directly to Covered California. Other than the individual applicant, no one may view, collect, or submit this form.
** Use the following guide for instructions on how to download the required pre-populated background forms:
29
CHAPTER 6:
CEC TRAINING – LEARNING
MANAGEMENT SYSTEM (LMS)
LEARNING MANAGEMENT SYSTEM
• The Learning Management System (LMS) is the online
training system used by Covered California.
• All prospect CECs are required to complete the ComputerBased Training (CBT) modules assigned to their LMS profile
and pass the corresponding exam.
• The CEC can expect to receive an email with LMS
credentials 3-5 days after their status has been set to “Ready
for Training.”
**A CEC is set to “Ready for Training” once their CEC Agreement and badge
photo have been uploaded and approved.
• The direct link to the LMS training site is:
https://learning.coveredca.com
31
LEARNING MANAGEMENT SYSTEM
The email with login information to LMS will come from the
following email address:
[email protected]
•
If the CEC does not receive their LMS credentials in the allotted time, please
instruct them to contact the training department at [email protected].
•
Because this email is auto-generated, some email networks might mistakenly tag
it as “spam.” Please ensure that your CECs have checked their spam/junk folder
and have added [email protected] to their “Safe
Senders” list prior to inquiring additional assistance.
•
Once the LMS email is received, CECs must log into the system and begin their
training immediately.
32
LEARNING MANAGEMENT SYSTEM
Additional information and
resources regarding CEC
training can be found on the
IPAS homepage at:
https://ipas.ccgrantsandassi
sters.org/
33
CHAPTER 7:
TRACKING YOUR CECS’ CERTIFICATION
AND TRAINING PROGRESS
TRACKING YOUR CEC’S CERTIFICATION
AND TRAINING PROGRESS
• The Primary Contact is responsible for monitoring the
certification and training process of their enrollment
counselors.
• Enrollment Counselors will be certified after meeting the
following requirements:
– Individual is affiliated with an Active CEE
– Individual submits a completed CEC agreement
– Individual completes the Certification Training and passes the
CEC Exam via LMS
– Individual receives background clearance
35
36
TRACKING YOUR CEC’S CERTIFICATION
AND TRAINING PROGRESS
CEE Status Board
• The CEE status board is available in IPAS and allows the entity to track the
certification process of all individuals in their counselor roster.
• To view your CEE Status board, simply login to your IPAS account at
https://ipas.ccgrantsandassisters.org/ and click on the speedometer icon as
shown on the screen shot below.
** Use the following guide for instruction on how to navigate the CEE/CEC Status
Board:
37
CHAPTER 8:
CoveredCA.com Accounts
for CECs
COVEREDCA.COM ACCOUNTS FOR CECS
Delegation Code:
• The CEC will receive an email with a delegation code and additional
information to create an account with Covered California 3-5 business
days after the CEC’s status is set to “Certified.”
• A CEC is set to “Certified” once they meet all of the following
requirements:
• Cleared background check
• Completed all training requirements
• Passed certification exam
• Are affiliated with an Active entity
39
COVEREDCA.COM ACCOUNTS FOR CECS
Delegation Code:
The delegation code email will come from the following email address:
[email protected] with subject:
“Information to set up your user account in CoveredCA.com”
**Upon receipt of a delegation code, share the following document with your CECs for
instruction on how to create an account with Covered California.
If the CEC’s delegation code email does not arrive in the allotted time:
•
•
Please instruct your CECs to check their spam/junk folder prior to inquiring further
assistance regarding their delegation code email.
Remember that this email is auto-generated and sent via a third party system called
Sendgrid. If your CEE’s email network has a strict firewall policy, emails sent from
Sendgrid may be bouncing. In this case check with your I.T. department
**Click here for more information on how to ensure you and your CECs are receiving all email
communication from Covered California, including those sent via Sendgrid.
40
COVEREDCA.COM ACCOUNT FOR CECS
Resending Your CEC’s Delegation Code
• If the CEC is unable to locate the Delegation Code email, or
accidentally deleted it, the Primary Contact can log into IPAS and
use the “Resend Delegation Code” feature to resend the email.
** Use the following guide for instructions on how to resend your CEC’s delegation code
email.
For any additional assistance, please contact
[email protected].
41
CHAPTER 9:
Badges
IDENTIFICATION BADGES
• A CEC badge is issued once the CEC has:
–
–
–
–
–
Completed all required training
Received background clearance
Been issued their delegation code email
Is affiliated with an Active CEE
Badge photo has been uploaded to IPAS
• The Primary Contact will receive an email when
their CECs have been certified.
43
IDENTIFICATION BADGES
• CECs are required to wear their identification
badge when assisting consumers. CECs are not
allowed to enroll consumers without a CEC badge.
• The CEE must upload the CEC’s photo when
adding the CEC to the counselor roster in IPAS.
** Use the guide provided in slide 31 (Guide: Adding New CECs) for
instructions on how to upload a photo.
44
IDENTIFICATION BADGES
Badge Photo Information:
• Photos must be:
–
–
–
–
Passport-style (shoulders up)
No hats, sunglasses or anything covering the face
Upright and front facing
In color and of high quality and between 70MB- 140MB
• Below are examples of acceptable photos
45
IDENTIFICATION BADGES
Badge Replacement Information
• Generally, CECs are allowed up to two free badge
replacements before being charged a processing fee.
• To request a replacement badge, complete the
following Replacement Badge Request Form and
upload it to “My Files” in IPAS.
• Please email IPA Program Support at
[email protected] if you have any
questions.
46
CHAPTER 10:
Using the CEE Dashboard
on CoveredCA.com
CEE DASHBOARD
Certified Enrollment Entity Dashboard:
• The CEE dashboard is accessed by logging into the CEE’s
CoveredCA.com account that was created with the verification
token they received (refer to slides 26- 29 for details).
• Once logged in, CEEs can view the list of applications in the
queue, but not the applications themselves.
• For example: if a CEC is no longer affiliated with your entity, or if the
CEC is going on leave, you will want to confirm there are no pending
applications on their dashboard by checking your CEE Dashboard
• CEEs can access the CEE dashboard to compare CEC
applications to the Payment Remittance Notice.
** The Remittance Notice is the “summary of payments” your CEE receives from Covered
California after each payment.
48
CEE DASHBOARD
This is what the CEE Dashboard homepage looks like.
CEEs can lookup consumers that are
currently being assisted by their CECs
49
CEC DASHBOARD
Certified Enrollment Counselor Dashboard:
• The CEC dashboard is accessed by logging into the
CEC’s CoveredCA.com account that was created with
the delegation code (refer to slides 43- 46 for details).
• The CEC dashboard keeps track of any consumers who
have delegated their application to the CEC and are
pending assistance and consumers who are currently
being assisted.
• CECs can assist new consumers with their online
application via the “Add New Individual” button located
on the CEC Dashboard.
50
CEC DASHBOARD HOMEPAGE
This is what the Certified Enrollment Counselor Dashboard homepage
looks like.
51
The following definitions explain the different terms used to track a
consumer’s enrollment status with Covered California:
52
CHAPTER 11:
CEE COMPENSATION
CEE Payment Guidelines
• For CEEs to receive compensation:
– The consumer’s application must be completed by a CEC who
is affiliated with your entity.
– The consumer’s application must be delegated by the
consumer to a CEC who is affiliated with your entity.
– The delegation must be accepted by the CEC prior to the
consumer’s coverage effectuation date.
– The consumer’s first monthly premium must be PAID IN
FULL to the Covered California Health Insurance
Company and reported back to Covered California by
the insurance company.
54
CEE Payments
Program Eligibility
Payment Amount
Covered CA Health Plan
$58 from Covered California
Medi-Cal
$58 from DHCS
Mixed Household (Medi-Cal + APTC/CSR)
$29 from DHCS
$29 from Covered California
• To receive payment for the Medi-Cal application:
• At least one person on the application has to be eligible for Medi-Cal
• At least one person on the application did not have Medi-Cal in previous
12 months
• Applicant cannot have had Medi-Cal in the 12 months preceding the
application month
55
Compensation Timeline
• Compensation is paid directly to the Certified Enrollment Entity
– Compensation to the CECs is determined by the Certified Enrollment
Entity
• The CEE will receive a summary of payment letter (remittance
notice) that details effectuated counselor enrollments
**Please Note: Compensation details are subject to change for the upcoming
Open Enrollment period
56
PAYMENT RECONCILIATION WORKSHEET
• Any discrepancies between the CEE Dashboard and Remittance Notice should be
reported through the Payment Reconciliation Form
• The form is available on the IPAS homepage: https://ipas.ccgrantsandassisters.org/
57
CHAPTER 12:
RECAP OF RESOURCES
Recap of Resources
IPAS Home page: https://ipas.ccgrantsandassisters.org/
•
•
The CEE Application login page
Houses CEE/CEC resources, such as: FAQs, Webinar Recordings, Job Aids, Forms, Worksheets,
and Training Information
Covered California (CalHEERS): http://www.coveredca.com/
•
•
•
Houses CEEs and CECs Covered California dashboard accounts
Where consumers enroll into a Covered California health plan
Where consumers can use the “Find Local Help” feature to find in-person assistance with their
online application
Print Shop: http://360.kpcorp.com/coveredca/Login.aspx
•
•
•
Site where CEEs can order collateral material from Covered California
Email questions about materials and orders
Request assistance logging in
59
Additional Resources
PRIMARY POINTS
OF
CONTACT:
CEE/CEC HELP LINE at 1-855-324-3147 8:00 a.m. – 6 p.m.
Call center line dedicated to CEEs and
CECs. Provides support related to:






General CoveredCA.com questions and system errors
CoveredCA.com login issues
CoveredCA.com CEE dashboard
CEE payment inquiries and Reconciliation Form
Interpreting CoveredCA eligibility results
Troubleshooting all issues with CoveredCA new applications, change requests
for current applications, and renewals of applications
CoveredCA CEC PIN resets

COVERED CALIFORNIA SERVICE CENTER: 1-800-300-1506
Covered California operated call center,

All CEC Helpline issues that arise outside of the business hours of the CEC
supporting activities related to:
Helpline
E-MAIL SUPPORT
FOR
IPAS: [email protected]

Adding or withdrawing CECs from an entity

Reporting changes to an entity’s contacts or sites
To assist CEEs/CECs in activities related to:

Updating the “Find Help Near You” information on CoveredCA.com

CEC certification status
CEC TRAINING HELP DESK: [email protected]
Email dedicated to assist CECs in activities 
Learning Management System (LMS) access
related to:

Training requirements, status and progress
PRINT SHOP RESOURCES: [email protected]
Active CEEs can purchase marketing
material to support enrollment assistance
services.
Access the print shop at: http://360.kpcorp.com/coveredca/Login.aspx
60
Additional Resources
KEY PROGRAM RESOURCES AVAILABLE
Payment Questions and Payment Reconciliation
Form
https://ipas.ccgrantsandassisters.org/
Program Resource Page
https://ipas.ccgrantsandassisters.org/
Program Webinars
Index of all program webinars
Tips of the Week E-mails
Index of all weekly emails
ON
IPAS
For information on payments review the 2/20/14 payment webinar. If the CEE
determines they did not receive payment for all applications effectuated by
appropriate date, download and complete the payment reconciliation form.
Program home page that list a wealth of program resources, including: Job Aids,
FAQs, Welcome to Answers and other important information
Index of all program webinar and topic areas covered, includes links to webinar
recording and presentation slides
These newsletters are equipped with the latest program updates, resources and
announcements related to CEEs and CECs and their role with Covered California.
CEC INFORMATION
CEC Agreement
Criminal Disclosure Form
Live Scan Request Form
Required form, CECs must submit
Required form, CECs must submit. Required to use pre-populated form in IPAS
exported from CEE application by primary contact
Official CEC Live Scan Request Form. Required to use pre-populated form in IPAS
exported from CEE application by primary contact
Live Scan Locations
Locate nearest Covered California approved location for Live Scan processing
Contact Live Scan at (877) 288-5519 or
[email protected]
Email with questions regarding fingerprinting or background check
61
Additional Resources
OTHER RESOURCES
Federal health care reform
www.healthcare.gov
www.healthcare.gov/center/regulations/index.html
Office of the Patient Advocate
www.opa.ca.gov
The Centers for Medicare and Medicaid Services’
Center for Consumer Information and Insurance
Oversight
http://cciio.cms.gov/
California Health Benefit Exchange
www.healthexchange.ca.gov
Department of Managed Health Care (DMHC) and
its programs
www.dmhc.ca.gov
California Department of Insurance
www.insurance.ca.gov
62