The time for action is now.  We must work together in the coming weeks to re-energize our outreach and enrollment efforts.  We want to highlight a few of the successful outreach best practices that enrollment assisters have discovered work well in local communities. Consider adopting these tactics in a way that would work in your community. Together we will keep the momentum going in the final nine weeks of open enrollment to help consumers better understand the facts about the law and motivate consumers to enroll. 

The three best practices highlighted in two examples below are: 1) hosting "computer bank" events, 2) holding events during non-traditional hours (like weekends and after work), and 3) leveraging partnerships to target youth and families.

Example of a Computer Bank Event at Non-Traditional Hours   Some assisters have found success in hosting computer bank events held at non-traditional hours.  During these events, multiple consumers sit at computers and enroll online, with assisters on hand to answer questions. These events have found success with numerous assister groups, including FoodBank of Monmouth and Ocean Counties in New Jersey and Great Plains Tribal Chairman's Health Board in North Dakota.  As another example, Health Council of South Florida, a CAC organization, through partnership with Enroll America and additional community organizations, hosts large scale computer bank enrollment events at Miami Dade College's massive computer labs - on both weekday nights and weekend afternoons.  Each Assister mans a section of 6-10 computers at a time - essentially computer pods - and walks consumers through the enrollment process. Students and members of the public have the opportunity to RSVP in advance (although walk-ins are welcome), and upon arrival each consumer checks in at the check-in station where the receptionist directs each individual to a pod that will best suit their needs. For example, if a consumer is Spanish or Creole speaking, they will be directed to a computer pod with a Spanish or Creole speaking CAC assister. 

While the events are targeted to young college students, they are also publicized to the larger public via 2,000 local organizations. The work of the Health Council of South Florida demonstrates the benefits of partnering with local universities and organizations and demonstrates how computer bank events maximize the impact and reach of individual assisters to result in higher enrollment completions.

Example of Partnerships to Target Youth and Families  An example of a partnership to target youth and families using the previously mentioned computer bank format is highlighted in the work of assisters in Tampa, FL.  Assisters in Tampa have partnered with the Mayor's office to conduct outreach and enrollment at nine of the busiest community recreation centers across Tampa.  In-person assisters, in close partnership with a local Navigator subgrantee, the Tampa Family Health Foundation, have at least two assisters at each center at least once a week between the hours of 4-7 pm or other non-traditional hours convenient to the target audience of young adults.  Each recreation center includes a computer lab with 15-20 computers which gives consumers a chance to learn about the Marketplace, browse for plans, and finish an application in a more private spot when they are ready. The mayor's office has also helped the group get media attention leading to more participants who end up enrolling in coverage. Secretary of Health and Human Services Kathleen Sebelius also drew a big crowd and media attention when she helped kick off the rec center project. The work of these Tampa assisters is a great example of productive partnerships and using computer banks during non-traditional hours to provide accessible enrollment assistance and outreach to the young and fit.

Thank you for your hard work and for your willingness to partner with us to reexamine and reinvigorate our outreach and enrollment efforts during the last ten weeks of open enrollment.  We are relying on you to get the word out and get people enrolled in coverage that works for them. 

We want to highlight items that are important to remember when assisting a consumer with documentation related to immigration status.  Consumers filling out the online application will need to attest to either being a U.S. Citizen, a naturalized or derived citizen , or in an eligible immigration status in order to be determined eligible to enroll in qualified health plans, to receive Advanced Payments of Premium Tax Credits or Cost-Sharing Reductions, and/or to be determined eligible for other Insurance Affordability Programs such as Medicaid or CHIP. Some consumers with various immigration statuses have experienced issues in submitting their application. For example, some consumers have received a yellow error screen at the end of the application process.  This may be caused by the way the data is handled in the Marketplace system.

*NEW NOTE* (UPDATED INFORMATION) Currently the data verification process is case-sensitive.To avoid triggering an error, please encourage consumers to enter their first name and last name on the application in all capital letters, omitting special characters (',/,- etc.) or any spaces before or after their name. Also, there is a helpful guide on healthcare.gov that gives a description of each of the immigration documents, outlines which document numbers will be requested for each document type, and provides guidelines for entering the document numbers.

Naturalized or Derived Citizens:
If a consumer attests to being a naturalized or derived U.S. Citizen on the application, he/she will be asked to provide information about their Naturalization Certificate or Certificate of Citizenship supporting their status. On the application, after a consumer attests to their status, the consumer will be given an option to choose one of these two documents and then will be shown fields to input key pieces of information that can be found on their document.

• The consumer will be asked to provide an alien number and either a Naturalization Certificate number or a Certificate of Citizenship number, depending on which document he/she has.

Both the alien number and certificate number are needed in order to verify the consumer's information.

We highly encourage assisters to recommend that applicants locate and input all document numbers, if possible, so that we can verify the immigration status in real-time. Doing this will increase the likelihood of a successful application submission.

Eligible Immigration Statuses:
If a consumer attests to having an eligible immigration status on the application, they will be asked to provide information about their most current immigration document that supports their status. On the application, there is a drop down field where they can select their document.

After a document is selected, a number of fields will appear requesting certain document numbers that can be found on the immigration document. The specific document numbers that are requested of applicants will depend on the type of document that the applicant has selected.  Again, there is a helpful guide on healthcare.gov that gives a description of each of the immigration documents, outlines which document numbers will be requested for each document type, and provides guidelines for entering the document numbers. If consumers have difficulty locating the document numbers requested, they can also call the Call Center for assistance.

The Marketplace uses the document type and associated document numbers to verify an individual's status with the Department of Homeland Security (DHS). Again, we highly encourage assisters to recommend that applicants locate and input all document numbers, if possible, so that we can verify immigration status in real-time. Doing this will increase the likelihood of a successful application submission.

Since some consumers may encounter difficulty entering the document numbers into the application - due to problems finding the required document numbers or errors when trying to submit an application -- these fields are optional, and not required, on the application.  Therefore, if a consumer has problems entering their document numbers on the application, they should be able to attest to having an eligible immigration status and continue to complete and submit the application without inputting all of the immigration status information.  Consumers who choose to omit their document information will be asked to provide a copy of their documentation to the Marketplace once they have completed the application.  The Marketplace will then manually verify the immigration documentation.  

We've compiled a few best practices for assisting consumers with regards to immigration status and documentation. 

1. 1.     *NEW TROUBLESHOOTING TIP*: To avoid triggering an error, please encourage consumers to enter their first name and last name on the application in all capital letters, omitting special characters (',/,- etc.) or any spaces before or after their name.  For example, JOHN DOE. This increases the likelihood of a smooth and swift verification of data, and increases the likelihood of a successful application submission.
2. 2.     Although many of the few fields in the immigration section of the application are labeled optional, we highly recommend that consumers input all information they have into all of the fields, or as many of the fields as possible. This increases the likelihood of a smooth and swift verification of immigration status, and increases the likelihood of a successful application submission.
3. 3.     We also encourage legal permanent residents with a green card, or I-551, to input both their correct alien registration number (which may be listed on the card as a USCIS #) and their correct card number into the application.  This increases the likelihood of a smooth and swift verification of immigration status, and increases the likelihood of a successful application submission. Those with other immigration statuses or documents should also complete the document fields to the extent possible.
4. 4.     In addition to the guide on healthcare.gov, there are helpful guides located on the USCIS.gov website that include color visuals of immigration document examples with the document numbers circled in red.  Many assisters find the  guide detailing the Legal Permanent Resident Card - its layout, where to find the document numbers, and how many digits the numbers should have - especially helpful.  We're also working to update Healthcare.gov with visuals and helpful information in the future.
5. 5.     If, after multiple attempts, the consumer is still encountering difficulty entering document numbers into the application or submitting the application, the consumer has the option to omit the numbers and try again to continue through the application to submission. In order to successfully submit and receive a determination, the consumer should be sure to attest to having an eligible immigration status when asked within the application process.  The eligibility notice should then provide instructions to the consumer to provide documentation in support of their attestation to the exchange for manual verification. The consumer should then upload supplemental documentation supporting their status through My Account or mail copies to the Marketplace.
6. If possible, we recommend that the consumer upload supplemental documentation through My Account, as a faster process for verification of immigration status, rather than mailing them.
   

   The following links on HealthCare.gov should be helpful if there are questions about documentation:

   1.  Information on Eligible Immigration Status Types
   2.  More Information on Eligible Immigration Status Types
   3.  Information for Naturalized or Derived Citizens
   4.  Information on Immigration Documentation and how to correctly put it into the application