Health Reform WK-EDGE CMS clarifies website translation requirements for enhanced direct enrollment entities
Monday, July 2, 2018

CMS clarifies website translation requirements for enhanced direct enrollment entities

By Sheila Lynch-Afryl, J.D., M.A.

Enhanced direct enrollment (EDE) entities serving customers in states with federally-facilitated exchanges (FFEs) in plan year 2019 must translate certain website content for individuals who are limited English proficient (LEP). In Frequently Asked Questions, CMS clarified that because the Spanish language is spoken by 10 percent or more of Texas’ LEP population, for plan years 2018 and 2019, issuers and web-brokers that offer an EDE pathway serving consumers in Texas must make available a Spanish-language version of the application user interface (UI) and have it audited (CMS Center for Consumer Information & Insurance Oversight Letter, June 20, 2018).

45 C.F.R. § 155.205(c)(2)(iv) requires exchanges, qualified health plan (QHP) issuers, and web-brokers to translate certain website content "into any non-English language that is spoken by a limited English proficient population that reaches 10 percent or more of the population of the relevant state" (see Specifics of amended language requirements unpacked in CMS guidance, April 6, 2016). With respect to the EDE pathway, the website content required to be translated includes the application UI. Further, pursuant to EDE program requirements, an auditor must verify that the Spanish-language version of the application UI is compliant with FFE requirements.

In addition, a direct enrollment entity must translate communications informing consumers of the availability of exchange-generated eligibility determination notices, critical communications that the consumer will no longer receive from the exchange, and any other critical communications that the entity provides. CMS will provide more information about EDE communications requirements for web-brokers and QHP issuers on its website.

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