Key Questions to Consider in Setting Up a Navigator Program

6. What types of technology will navigators need access to?

Federal agencies predict that the majority of consumers who get coverage through exchanges will apply online.⁵⁶ Navigators will help them do this, and they can also extend the reach of web-based enrollment through the use of portable and community-based access to technology and electronic resources. 

Navigators will need access to technology and electronic resources in the community.

Providing assistance with accessing and completing online applications will be an essential service for many consumers who do not have regular access to computers or the Internet, or who have limited experience using technology. Navigators should establish relationships with community-based institutions that can provide publicly accessible computers, scanners, and printers. Navigators should also have their own portable electronic devices, such as laptops or tablets with wireless capability and cell phones that can be used to upload documents.

Creating a specialized enrollment portal will enhance navigator efficiency and effectiveness.

When designing exchange websites and enrollment tools, states should consider creating a specialized portal that would enable navigators to submit coverage applications on behalf of consumers. Such portals would also provide navigators with the capacity to track information on enrollment, eligibility status, and other actions that need to be taken, such as submitting documentation.

The UX 2014 project design for a consumer-friendly exchange interface, which can be used by any state, includes a model enrollment portal for assisters.⁵⁷ This type of portal can help navigators expedite the enrollment process; assist consumers with resolving problems; ensure successful enrollment for consumers whose applications cannot be processed in real time; and provide assistance post-enrollment, for example, with reporting changes or renewing coverage. The portal will also tag applications with information that identifies which assister provided help, allowing exchanges to collect data that will help monitor navigator performance. 

An assister portal could work like the database platform used by the HelpLine operated by Health Care for All, a consumer advocacy nonprofit in Massachusetts. HelpLine counselors sign privacy agreements with consumers who call for assistance, which allows the program to receive and track updates in consumers’ enrollment status. Counselors collect information using the HelpLine database as they assist individuals with applying for coverage. The database is updated as the program receives new information about a consumer’s coverage status (such as changes in enrollment and eligibility status, pending actions, and requests for documentation or renewal) that the state sends to the program daily in a password-protected spreadsheet and in paper notices. Counselors are then able to follow up with consumers to ensure that they have also received the notices that are sent to the program, understand the information provided, and receive the assistance needed with any action that may be required. When consumers who did not originally apply for coverage through the HelpLine call the program for assistance, counselors are also able to log into a state database, called the Virtual Gateway, to look up information about consumers’ coverage status.⁵⁸

Access to consumer information should be integrated for all consumer assistance entities.

All entities that help consumers enroll in or resolve problems with exchange coverage should be able to look at the data on an individual’s eligibility and enrollment status (with the consumer’s permission). This will ensure that navigators and other assisters, including exchange call center representatives, can effectively collaborate to quickly and efficiently resolve consumer problems.

SHIP Tips: Technology

• Schedule enrollment assistance clinics in places where technology is publicly accessible, such as libraries and schools.
• Equip counselors who are out-stationed at sites in the community, or who are conducting direct outreach, with laptops that have wireless capability.⁵⁹
• Provide online resources and reference tools that counselors can access from any location.⁶⁰
• Use a centralized, web-based data collection system that allows counselors to record and update information while assisting consumers⁶¹ (but be sure to leave consumers a paper record of any enrollment transactions).

[Back: Key Question #5] [Next: Key Question #7]