Colorado’s Approach to Developing the Single Streamlined Application (SSAp) March 26, 2013 Merged Advisory Group Meeting
Background Beginning in 2014, all states are required to use a single streamlined application (SSAp) provided by the U.S. Secretary of Health and Human Services or use a Secretary approved alternative for applicants who want to see if they are eligible to receive help paying for health coverage (Medicaid, CHP+ or Advanced Premium Tax Credits and Cost Sharing Reductions) 2
Vision of the SSAp Facilitate a “no wrong door” to determine eligibility for all insurance affordability programs Provide a dynamic application with built in smart logic to streamline the process and verify information real-time if possible The SSAp will be used to How Can the SSAp be filed? Who Can file a SSAp? determine eligibility for… • Via an internet web site • An applicant • Enrollment in QHPs • By telephone • An adult in the applicant’s • Advance payment of the household or family premium tax credit • By mail • Authorized representative • Cost-sharing reductions • In person • If the applicant is a minor • Medicaid and CHP+ or incapacitated, someone acting responsibly for an applicant 3
Background CMS guidance—released proposed data elements in July 2012, then proposed online application released in December 2012 and updated guidance released again in January 2013 for online and paper If Colorado wants to make any changes to the proposed single streamlined application we have to get approval from CMS We have jointly identified some areas where the application could be improved and plan to submit our proposal to CMS for review and approval 4
General Flow of Federal SSAp Program Specific Create Account Income Questions Special Review & Sign Privacy/Getting Circumstances - Eligibility Results Started (e.g. disabilities & - Required Documents Needed pregnancy) - Provide Signature Gather Household Help Paying for Plan enrollment size & Coverage? (if applicable) demographic info 5
COHBE and HCPF Alignment Process-to-date – COHBE convened an advisory group meeting in June 2012 to discuss the initial federal release of data elements in the SSAp. – The COHBE Board voted on August 13, 2012 to use the baseline application data elements set forth in federal guidelines, with the addition of primary care provider, gender neutral identifiers and inclusive relationship reporting terminology, and to clarify what is needed to properly screen for eligibility. – COHBE and HCPF policy staff met during December 2012- March 2013 to discuss the December 2012 & January 2013 federal guidance on the SSAp 6
COHBE and HCPF Alignment Process-to-date – HCPF and DHS discussed incorporation of the SSAp with the Public Assistance Application at the Work Support Strategies (WSS) conference in February 2013 – HCPF, DHS, and county workgroup convening to incorporate SSAp into Public Assistance Application – HCPF, DHS, PEAK Outreach, counties and stakeholders workgroup convening to incorporate SSAp into PEAK 7
COHBE and HCPF Alignment Process-to-date – Staff outlined areas in the federal SSAp guidance where the state might want to take a different approach guided by: • Questions currently asked in the CO Medical Assistance Application and in PEAK • Functionality of current systems (i.e. CBMS) • Consumer focused questions needed to make an eligibility determination for all insurance affordability programs • Clear and simple questions that don’t make it burdensome for the consumer to apply – Changes fell into three major buckets • Technical restrictions • Unclear language • State-specific requirements 8
COHBE/HCPF Single Streamlined Application Proposed Changes Technological Limitations Texting: Functionality not available for October 1 st (both, online & paper) Self-employment: Requesting gross income instead of net due to current data entry fields (both) Unclear Language Authorized Representative: Made it more clear to the consumer what we were asking and how they can verify an authorized representative (online) General clarity. Examples: Get help paying for “some or all” of your health insurance (online) Clarify how to report monthly income from single employer if it includes lump sum payments (online) Highlighted the need for applicants to list themselves first (paper) Highlighted that SSN is optional if NOT applying (paper) 9
COHBE/HCPF Single Streamlined Application Proposed Changes Additional Questions Social Security Number: Allow consumer to give a reason why they are without a SSN (both) Self-employment: Break-out of possible expenses (both) Q: Expect projected income to be higher or lower?: Added option C for individuals who expect their income to stay the same (online) Demographic information: Added Primary Care Provider & Were You Uninsured question (both) Pregnancy: Added due date field (paper) Retro: Added dates of service field for Medicaid retro request (paper) Additional Modifications Access to state health insurance: Removed this question due to change in legislation (both) Renewal of coverage: Moved this question higher up so it didn’t get lost (paper) 10
What’s Next? Continue to gather stakeholder feedback • • Review and incorporate changes (if any) from SSAp and guidance to be released by CMS • Provide CMS/CCIIO with suggested changes and gain approval • Develop online and paper SSAp 11
Stakeholder Input • What is important to you and the communities you work with? 12
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