Cal. Code Regs. Tit. 10, § 6706 - Training and Certification Standards

(a) All entities who apply to become a PBEE shall have their Authorized Contact complete training for the management of PBEs prior to any affiliated PBEs carrying out any consumer assistance functions under this Article.
(b) To ensure that all PBEs are knowledgeable about the Individual Exchange, all individuals or entities who carry out enrollment assistance functions shall complete training in the following subjects prior to carrying out any enrollment assistance functions pursuant to this Article:
(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;
(2) The range of Insurance Affordability Programs, including Medi-Cal, and other public programs;
(3) The tax implications of enrollment decisions;
(4) Eligibility requirements for Advanced Premium Tax Credit (APTC), as defined in Section 6410 of Article 2 of this chapter, and cost-sharing reductions, and the impacts of APTC 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 the 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 the Individual Exchange marketplace and differences among health plans;
(11) Privacy and security standards applicable under 45 CFR § 155.260 for handling and safeguarding consumers' personally identifiable information;
(12) Working effectively with, and not discriminating against, individuals of various racial and ethnic backgrounds, persons with limited English proficiency, people with a full range of 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; and
(15) Applicable administrative rules, processes and systems related to Exchanges and QHPs.
(c) Training pursuant to this Section shall be provided by the Exchange through computer-based training, or through another channel at the discretion of the Exchange.
(d) PBEs shall pass the exam administered by the Exchange on an annual basis to maintain certification.

Notes

Cal. Code Regs. Tit. 10, § 6706

Note: Authority cited: Section 100504, Government Code. Reference: Section 100503, Government Code; and 45 Code of Federal Regulations, Sections 155.205(d), 155.415, 155.260 and 156.1230.

1. New section filed 9-30-2013 as an emergency; operative 9-30-2013 (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 4-1-2014 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 4-1-2014 as an emergency; operative 4-1-2014 (Register 2014, No. 14). A Certificate of Compliance must be transmitted to OAL by 6-30-2014 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 6-26-2014 as an emergency; operative 7-1-2014 (Register 2014, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-29-2014 or emergency language will be repealed by operation of law on the following day.
4. New section refiled with amendment of subsections (a), (b), (b)(4) and (d) 10-2-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 ( Stats. 2014, c. 31 ); operative 10-2-2014 (Register 2014, No. 40). A Certificate of Compliance must be transmitted to OAL by 9-30-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.

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