Expanding Health Care Coverage

Grantee Name

Health Research, Inc.

Funding Area

Expanding Health Care Coverage

Publication Date

May 2018

Grant Amount


Grant Date:

June 2014 – December 2016

The first open enrollment period of the Affordable Care Act’s insurance coverage expansions resulted in nearly 1 million New Yorkers gaining public or private insurance coverage.

Much of this enrollment surge relied on an army of in-person assistors to provide one-on-one, face-to-face guidance to those seeking coverage. The New York State of Health Marketplace (New York’s state-operated exchange) funded nonprofit organizations and trained their staff members, called enrollment Navigators, to provide independent, neutral, direct enrollment assistance. At the time, the New York State of Health Marketplace funded, trained, and certified 651 Navigators.

In addition, a large number of in-person enrollment services were provided by 4,103 certified application counselors (CACs) throughout New York State. New York offered training and support, but not funding, for CACs to provide in-person enrollment assistance. Navigators and CACs went through an identical intensive multiday training course to gain certification.

Going into the second round of open enrollment, NYHealth awarded a grant to Health Research, Inc. (HRI), the fiscal sponsor for New York State agencies, to support a continuing education and training program for both Navigators and CACs; develop training materials on specialized topics and populations; and create a recognition and awards program for assistors.

Outcomes and Lessons Learned

  • Sponsored three sessions of a longer nine-session training series (of which NYHealth was designated an official co-sponsor) conducted by webinar, as part of this continuing education program;
  • Hired nationally known external presenters and trainers for sessions on the following topics: immigration rules, cultural competency and young adults, and health plan selection;
  • Made training materials available on the New York State Department of Health’s website, as well as a recognition and awards program for Navigators and CACs who successfully completed the training program and showed innovative ideas to support enrollment; and
  • Provided assistors with a variety of fact sheets and reference guides relevant to certain training session topics, along with flash drives containing all of the training materials.

The training program for assistors was successful, with more than 12,000 live log-ins during the webinar presentations and additional online replays of the archived materials. Based on surveys of participants, more than 90% of assistors reported that the trainings were helpful and that the webinars increased their knowledge of the topic.

Because many of the training consultants requested no payment or only modest compensation, and supply costs were lower than anticipated, total grant spending was less than expected. With NYHealth’s approval, the savings allowed the Marketplace to offer webinar trainings to assistors for two years rather than only one. Other remaining grant funds were used to develop educational videos directly for consumers that explained what to do once they had enrolled in a health plan. These animated videos were produced using concepts drawn from the Your ROADMAP to Health document created by the Centers for Medicare & Medicaid Services and housed on the New York State of Health website. The remaining funds also allowed for the production of consumer education videos in Spanish and Mandarin, the two most commonly spoken languages of Marketplace enrollees after English.

As a result of the training, assistors started the 2015 and 2016 open enrollment periods with a deeper understanding of the eligibility rules and processes; Marketplace health plan choices and key factors for consumers in making an informed selection; how the renewal process would work; and tools for communicating with consumers from a variety of backgrounds. Investing in the continuing education of in-person assistors has been vital to the success of the Marketplace.

Given the success and relatively low costs of this work, the Marketplace continued the training program for the 2017 open enrollment period and fully integrated it as a permanent offering for its assistors.

Co-Funding and Additional Funds Leveraged: N/A