The Service Tree lists all services in "branched" groups, starting with the very general and moving to the very specific. Click on the name of any group name to see the sub-groups available within it. Click on a service code to see its details and the providers who offer that service.
Affordable Care Act Insurance Information/Counseling
Certified Application Counselor Programs
Programs other than official navigators or in-person assisters (IPAs) that connect consumers to the Affordable Care Act's expanded health care options and facilitate enrollment through the marketplace. The marketplace certifies employees and volunteers of organizations such as health clinics and hospitals that must meet training requirements, security standards and conflict of interest rules similar to those governing IPAs and navigators.
Federal Health Insurance Marketplace Call Center/Website
A consumer-focused website (HealthCare.gov) and a 24-hour consumer call center operated by the Centers for Medicare and Medicaid Services (CMS) whose purpose is to ensure that individuals who need health coverage have the information they need to make choices that are right for themselves and their families or their businesses under the Affordable Care Act. When fully operational, consumers will be able to create accounts, complete an online application, and shop for qualified health plans. Key features of the website will include integration of social media, sharable content, and engagement destinations for consumers to get more information. Web chat functionality will be available to support additional consumer inquiries. The ongoing functions of the call center are to serve consumers who are uncomfortable with a computer environment, handle coverage complaints, work with people whose income changes may impact their eligibility for a subsidy or other benefits and help people who have other questions that haven't been answered locally.
Programs permitted by the Affordable Care Act (ACA) that provide in-person assistance personnel (also known as non-navigator assistance personnel) to help people understand and access insurance coverage through the marketplace. In a state-based marketplace, in-person assistance personnel may serve as a part of an optional, transitional program that the state can set up before its marketplace is economically self sustaining, and before its navigator program is fully functional. Though they perform the same functions as navigators, in-person assistance personnel are funded through separate grants or contracts administered by a state. In person assistance personnel must also complete comprehensive training.
Programs mandated by the Affordable Care Act (ACA) that help individuals who want to purchase insurance, and small businesses that need to provide health insurance for their employees, understand the qualified private health plans that are available within the marketplace and guide them through the enrollment process. The navigator conducts public education activities to raise awareness about the marketplace; distributes fair, accurate and impartial information concerning enrollment including information that acknowledges other health programs such as Medicaid and the Children’s Health Insurance Program (CHIP), and the availability of premium tax credits and cost-sharing reductions; provides referrals for consumers with a grievance, question or complaint; and offers information that is culturally and linguistically appropriate to meet the needs of the population served by the marketplace. Navigators are trained to offer expertise on each health insurance plan with the objective of empowering individuals to make informed choices and to facilitate selection of a qualified health plan; and either have or can easily establish relationships with the target population.
Small Business Health Options Programs
Programs mandated by the Affordable Care Act and operated by health insurance marketplaces that facilitate the ability of qualified employers to provide their employees and their dependents with access to qualified health plans (QHPs). States may elect to create an independent governance and administrative structure for the SHOP so long as the SHOP coordinates and shares relevant information with the marketplace operating in the same service area; and in some jurisdictions, the SHOP functions are being handled by separately organized navigator and/or assister programs that specialize in working with small businesses.