This policy applies to certified assisters.
Terms and Definitions
- Assisters: Refers to certified brokers and navigators.
- Preferred assister: Broker agencies and navigator organizations who agree to receive direct consumer referrals from MNsure.
- Preferred assister report: Excel file list of consumer referral emails sent to a preferred assister. The report includes consumer first and last name, consumer phone number and the date the referral was sent via email to the preferred assister.
To connect consumers with application and enrollment assistance MNsure is partnering with navigator organizations and broker agencies to establish a lead referral process.
Preferred assisters agree to:
- Contact a referred consumer as soon as possible, but no later than within one to two business days.
- Have the capacity to complete appointments within two weeks from receiving a referral from MNsure.
- Provide MNsure with a designated contact point for sending leads and immediately notify MNsure if there is a change to the contact information.
- Complete and return the preferred assister report on a schedule to be determined by MNsure with all required fields filled in.
- Immediately notify MNsure if the preferred assister is no longer able to meet any of these expectations.
MNsure will provide preferred assisters with the following:
- Consumer leads sent using a secure method that include consumer contact information and relevant information about the consumer’s application and/or enrollment status and type of assistance requested.
- Regular preferred assister reports that document the leads that have been generated.
- A timely response to requests to update contact information or suspend preferred assister activities.
MNsure will track success of the program as well as the performance of each preferred assister using the data from completed preferred assister reports. MNsure reserves the right to review preferred assister status if minimum expectations are not being met.
Generating Preferred Assister Leads
- Upon establishing that a consumer requires in-person assistance and is not currently working with an assister, a MNsure Contact Center representative will generate a lead to a preferred assister.
- The representative will identify the appropriate assister type for the consumer’s situation.
- If the consumer has not completed an application, the case will be referred to a preferred navigator organization.
- If the consumer has completed an application and has a public program determination, the case will be referred to a preferred navigator organization.
- If the consumer has completed an application and has a QHP determination, or specifically requests assistance regarding plan selection, the case will be referred to a preferred broker agency.
- The representative will assign the consumer’s case to the preferred assister of the correct type in closest proximity to the consumer.
- The representative will include the following information in the lead:
- Does the consumer have an active account?
- What is the consumer’s user log in?
- Does the consumer have an active application?
- What is the household’s current determination(s)?
- Why is the consumer seeking help from an assister?
- What guidance was the consumer provided?
- Did the consumer consent to have their information sent to an assister?
- The lead will be automatically sent through a secure method to the designated preferred assister contact point.
Completing Preferred Assister Reports
- MNsure will send a preferred assister report to a designated contact person on a schedule to be determined by MNsure. The report will be sent via secure email and will contain the following information for each lead that has been sent to the preferred assister:
- Consumer first and last name: The first and last name of the consumer who requested assistance.
- Consumer phone number: The phone number of the consumer who requested assistance.
- Date the referral sent to the assister: The date that the referral email was sent by MNsure.
- The preferred assister will review the report complete the following fields for each lead listed in the report:
- Contact Made (Y/N): This field captures whether or not the consumer was contacted by the assister. Assister must select one option, Yes or No.
- Contact Date: This field captures the month, day and year the consumer was contacted. If contact was made, a date must be entered as MM/DD/YY.
- Resolution: This field captures the result of a consumer referral. This is a required field even if contact was not made. Select one of the following resolutions from the drop-down box:
- Eligible for Medical Assistance
- Eligible for MinnesotaCare
- Enrolled in QHP
- Eligible for QHP, no enrollment
- No longer needs assistance
- Referred to other certified assister
- Unable to contact
- Assisted with technical issue only
- Contact made, appointment scheduled
- Comments: This field is optional and may be used for any notes that help clarify the outcome of the consumer referral.
- The completed report should be sent by secure email to email@example.com.
Preferred Assisters Contacting MNsure
- If there is a change to the designated contact point, a preferred assister must immediately notify MNsure by emailing the updated information to firstname.lastname@example.org.
- If a preferred assister is unable to accept any new leads or can no longer complete appointments within two weeks of receiving a lead, they must immediately notify MNsure at email@example.com.