CMS names counties requiring health plan language assistance

The Centers for Medicare and Medicaid Services has released the 2015 list of counties where health plans must provide information in a language other than English for individuals, as well as employers buying through Small Business Health Options Program (SHOP), on the federally-facilitated marketplace.

Under the Affordable Care Act, non-grandfathered health plans and carriers are required to provide a summary benefits of coverage (SBC) and uniform glossary  in a “culturally and linguistically appropriate matter” when more than 10% of a population in a county speaks a language other the English. Those languages include Spanish, Chinese, Tagalog and Navajo. (The full list can be viewed here)

The requirements apply to a participant’s residence, or where the SBC is sent, not the location of the employer’s business. Benefit advisers and their employer clients should cross-reference the county list with employee address records to evaluate compliance needs.

“Providing people with ACA assistance in their native language is a huge part of making sure all Americans have access to the coverage they need at a price they can afford,” says a spokeswoman for the National Association of Health Underwriters. “This is an issue that we are concerned about, and we are working with many people to ensure that this happens.”

“The carriers provide the necessary translations of documents for clients who need them, in our case in Idaho typically in Spanish,” says Hyatt Erstad of Erstad & Company.

The carriers also have call centers that clients can reach out to for language assistance, “and these numbers appear on claims and appeals notices and SBCs as well as other client communications,” he adds.

When agents and brokers register to sell through the federally-facilitated marketplace, commonly referred to as Healthcare.gov, they indicate if they are fluent in other languages or skill sets, explains Julian E. Lago of CareOne Advocates in Boynton Beach, Fla., and vice president of NAHU’s region five.

Lago, who is fluent in Spanish, says most of the people he enrolled using Spanish did not come to him from CMS but rather direct referrals. Speaking an enrollee’s native tongue provides a “bonding that … is invaluable” when enrolling for something as important as health insurance, Lago says. He explains it is similar to other advisory services, such as medical professionals, accountants and lawyers.

The 2015 list, which is updated annually, includes the first county in Missouri, new counties in other states, and some counties have dropped off the list.

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