Cal. Code Regs. Tit. 10, § 6660 - Training Standards

(a) All individuals or entities who apply to become a Certified Enrollment Entity shall complete training for the management of Certified Enrollment Entities prior to any affiliated Certified Enrollment Counselors carrying out any Consumer Assistance functions.

(b) To ensure that all Certified Enrollment Counselors are prepared to serve both the individual Exchange, all individuals or entities who carry out Consumer Assistance functions shall complete training in the following subjects prior to carrying out any Consumer Assistance functions:

(1) QHPs (including the metal levels described at 45 C.F.R. § 156.140(b)), and how they operate, including benefits covered, payment processes, rights and processes for appeals and grievances, and contacting individual plans;

(2) The range of insurance affordability programs, including Medicaid, the Children's Health Insurance Program, and other public programs;

(3) The tax implications of enrollment decisions and the available resources for consumers who require tax advice and assistance with tax preparation;

(4) Eligibility requirements for premium tax credits and cost-sharing reductions, and the impacts of premium tax credits on the cost of premiums;

(5) Contact information for appropriate federal, state, and local agencies for consumers seeking additional information about specific coverage options not offered through the Exchange;

(6) Basic concepts about health insurance and the Exchange; the benefits of having health insurance and enrolling through an Exchange; and the individual responsibility to have health insurance;

(7) Eligibility and enrollment rules and procedures, including how to appeal an eligibility determination;

(8) Providing culturally and linguistically appropriate services;

(9) Ensuring physical and other accessibility for people with a full range of disabilities;

(10) Understanding differences among health plans;

(11) Privacy and security requirements in 45 C.F.R. § 155.260 for handling and safeguarding consumers' personally identifiable information;

(12) Working effectively with individuals with limited English proficiency, people with disabilities, people of any gender identity, people of any sexual orientation, and vulnerable, rural, and underserved populations;

(13) Customer service standards;

(14) Outreach and education methods and strategies;

(15) Applicable administrative rules, processes and systems related to Exchanges and QHPs; and

(16) Procedures for assisting consumers with voter registration in compliance with Chapter 6 of the California Elections Code.

(c) Training shall be provided by the Exchange through instructor-led training or computer-based training.

(d) Certified Enrollment Counselors shall pass an exam testing the subject matter in subdivisions (b)(1)-(16), which shall be administered by the Exchange on an annual basis, in order to maintain certification with the Exchange.

Notes

Cal. Code Regs. Tit. 10, § 6660

1. New section filed 7-15-2013 as an emergency; operative 7-15-2013 (Register 2013, No. 29). A Certificate of Compliance must be transmitted to OAL by 1-13-2014 or emergency language will be repealed by operation of law on the following day.
2. Repealed by operation of Government Code section 11346.1(g) (Register 2014, No. 7).
3. New section filed 2-10-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 2-10-2014 (Register 2014, No. 7). A Certificate of Compliance must be transmitted to OAL by 5-12-2014 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 5-12-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 5-12-2014 (Register 2014, No. 20). A Certificate of Compliance must be transmitted to OAL by 8-11-2014 or emergency language will be repealed by operation of law on the following day.
5. New section refiled 7-21-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats 2014, c. 31); operative 7-21-2014 (Register 2014, No. 30). A Certificate of Compliance must be transmitted to OAL by 7-15-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
6. New section, including amendment of subsection (b)(16), refiled 12-12-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats 2014, c.31); operative 12-12-2014 (Register 2014, No. 50). A Certificate of Compliance must be transmitted to OAL by 7-15-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
7. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government Code section 100504(a)(6) to change the date upon which a Certificate of Compliance must be transmitted to OAL. Pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of Compliance must be transmitted to OAL by 2-10-2017 or the language in the emergency order of 12-12-2014 will be repealed by operation of law on the following day (Register 2015, No. 38).
8. Certificate of Compliance as to 7-21-2014 order, including further amendment of section, transmitted to OAL 11-6-2015 and filed 12-23-2015 (Register 2015, No. 52).
9. Amendment of subsection (b)(3) filed 12-12-2016 as an emergency; operative 12-12-2016 (Register 2016, No. 51). Pursuant to Government Code section 100504, this is a deemed emergency. A Certificate of Compliance must be transmitted to OAL by 12-12-2021 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsection (b) filed 3-7-2018; operative 3-7-2018 pursuant to Government Code section 11343.4(b)(3) (Register 2018, No. 10).
11. Editorial correction of HISTORY 9 (Register 2021, No. 13).
12. Certificate of Compliance as to 12-12-2016 order, including amendment of subsections (b)(3) and (b)(16), transmitted to OAL 8-27-2021 and filed 10-7-2021; amendments effective 10-7-2021 pursuant to Government Code section 11343.4(b)(3) (Register 2021, No. 41).

Note: Authority cited: Section 100504, Government Code. Reference: Sections 100502 and 100503, Government Code; and 45 C.F.R. §§ 155.205, 155.210 and 155.260.

1. New section filed 7-15-2013 as an emergency; operative 7-15-2013 (Register 2013, No. 29). A Certificate of Compliance must be transmitted to OAL by 1-13-2014 or emergency language will be repealed by operation of law on the following day.
2. Repealed by operation of Government Code section 11346.1(g) (Register 2014, No. 7).
3. New section filed 2-10-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 2-10-2014 (Register 2014, No. 7). A Certificate of Compliance must be transmitted to OAL by 5-12-2014 or emergency language will be repealed by operation of law on the following day.
4. New section refiled 5-12-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 5-12-2014 (Register 2014, No. 20). A Certificate of Compliance must be transmitted to OAL by 8-11-2014 or emergency language will be repealed by operation of law on the following day.
5. New section refiled 7-21-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats 2014, c. 31 ); operative 7-21-2014 (Register 2014, No. 30). A Certificate of Compliance must be transmitted to OAL by 7-15-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
6. New section, including amendment of subsection (b)(16), refiled 12-12-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats 2014, c. 31 ); operative 12/12/2014 (Register 2014, No. 50). A Certificate of Compliance must be transmitted to OAL by 7-15-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
7. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government Code section 100504(a)(6) to change the date upon which a Certificate of Compliance must be transmitted to OAL. Pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of Compliance must be transmitted to OAL by 2-10-2017 or the language in the emergency order of 12-12-2014 will be repealed by operation of law on the following day (Register 2015, No. 38).
8. Certificate of Compliance as to 7-21-2014 order, including further amendment of section, transmitted to OAL 11-6-2015 and filed 12-23-2015 (Register 2015, No. 52).
9. Amendment of subsection (b)(3) filed 12-12-2016 as an emergency; operative 12-12-2016 (Register 2016, No. 51). A Certificate of Compliance must be transmitted to OAL by 12-12-2021 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
10. Amendment of subsection (b) filed 3-7-2018; operative 3/7/2018 pursuant to Government Code section 11343.4(b)(3) (Register 2018, No. 10).