SHIBA Volunteer Handbook - Mike Kreidler

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SHIBAvolunteer handbookInsurance Consumer Hotline: (800) 562-6900Administrative Office: (360) 725-7073PO Box 40255Olympia, WA. 98504-0255Email: shiba@oic.wa.govWeb: www.insurance.wa.gov/shibaUpdated October 2020

MIKE KREIDLERSTATE OF WASHINGTONSTATE INSURANCE COMMISSIONEROLYMPIA OFFICE:INSURANCE BUILDINGP.O. BOX 40258OLYMPIA, WA 98504-0258Phone: (360) 725-7000OFFICE OFINSURANCE COMMISSIONERDear SHIBA Volunteer:I believe we all have the opportunity to make a difference in the communitieswhere we live. Volunteers with the Statewide Health Insurance Benefits Advisorsknow this well. Our volunteers help others gain access to the health care coveragethey need and deserve. They see firsthand the ways they make a difference in thelives of others, and how much they are key to SHIBA’s success in communitiesaround the state.I am very happy you have decided to volunteer with SHIBA. Our staff will train youto provide information about health care coverage, insurance, public healthprograms, fighting fraud and more. I believe your experience as a volunteer forSHIBA will be exciting and rewarding. Working together, we all can make adifference.Thank you for this important commitment.Sincerely,Mike KreidlerInsurance Commissioner

SHIBA volunteer handbook Updated October 2020 Page 4

Table of ContentsWelcome! . 9Office of the Insurance Commissioner. 10Overview . 10Role . 10About State Health Insurance Assistance Programs and SHIBA . 12SHIPs . 12SHIBA mission statement . 12Who we are . 13SHIBA history . 13SHIBA services . 13SHIBA staff and resources . 14SHIBA staff contacts . 15Senior Medicare Patrol . 15Volunteer Risk Program Management (VRPM) Policies and working with theAdministration for Community Living (ACL) . 15Volunteer selection & certification process . 17Recommended volunteer qualifications . 17Volunteer roles and length of service. 18Path to becoming a certified SHIBA volunteer. 20Certification: Acceptance and appointment. 23Next steps: Start working with clients. 25Next steps: Attend required monthly continuing education . 29Supervision and performance management. 31SHIBA volunteer rights and responsibilities . 31Volunteer coordinator responsibilities . 34Probationary period. 34Volunteer records maintenance. 34The SHIBA scope . 36Duties within a Medicare counselor volunteer’s scope . 36Duties NOT within a volunteer’s scope . 37Refusing volunteer assignments . 38SHIBA volunteers provide referrals . 38Celebrating SHIBA volunteers . 39Self-care . 39Recognition . 39SHIBA policies and procedures . 40Introduction . 40SHIBA volunteer handbook Updated October 2020 Page 5

VRPM . 40Representing SHIBA . 41Public appearance . 41Conflict of interest . 41Accepting compensation, gifts, gratuities and honoraria . 43Confidentiality . 43Reporting time. 44Using SHIBA resources . 45Using social media . 46Information technology . 46SHIBA email addresses. 47Working with friends and relatives . 48Impartiality . 49Labor disputes . 50Non-discrimination and anti-harassment . 50Minors . 51Associated definitions . 51Prohibited conduct . 52Reporting incidents . 54Investigation. 54Volunteer liability . 55Evaluations or feedback from sponsors and trainers . 56Grievance procedures . 57Resignation, dismissal and leaves of absence . 57My SHIBA . 62Volunteer and sponsor webpages . 62Publications and materials . 63SHIBA-approved materials . 63Publication standards . 63Volunteer training materials. 63Reporting – STARS . 64Why the information is important . 64How STARS benefits SHIBA . 64Using state resources . 65OIC travel reimbursement. 65SHIBA Medicare News . 66SHIBA News Flash . 67What is SHIBA News Flash? . 67How can I sign up to get SHIBA News Flash? . 67SHIBA volunteer handbook Updated October 2020 Page 6

How do I cancel getting SHIBA News Flash by email or text message? .67I don’t use email or text messaging. How can I get copies of SHIBA News Flash?. 67Workplace safety . 68Contacting law enforcement . 68Accidents and injuries . 68Insurance . 69Domestic violence . 69Children . 70Elders and disabled . 70Animals . 70VRPM policies . 71SHIBA volunteer handbook Updated October 2020 Page 7

SHIBA volunteer handbook Updated October 2020 Page 8

Welcome!Thank you for joining the Statewide Health Insurance Benefits Advisors, or SHIBA.We appreciate and value your contribution of time, talent, enthusiasm andenergy in helping others navigate Medicare.The purpose of this handbook is to guide you in your volunteer experience withSHIBA and to give you a solid foundation of SHIBA’s mission, policies, proceduresand program responsibilities. A clear understanding of expectations is thefoundation for a safe and positive environment for all SHIBA volunteers and staff.While the content is intended to inform you of your responsibilities as avolunteer, it is also intended as a reference if you have any questions during yourvolunteer service with SHIBA.To assist you in learning about SHIBA and about specific volunteer responsibilities,we ask that all volunteers become familiar with and follow the information,guidelines and requirements presented in this handbook. Please read thishandbook carefully and keep it for reference.The content in this handbook may be modified at any time in order to provide youwith the most updated information available.If you have any questions or concerns, don’t hesitate to let us know by contactingus at shiba@oic.wa.gov.Thank you for being a part the SHIBA team and we hope you find this to be arewarding experience!SHIBA volunteer handbook Updated October 2020 Page 9

Office of the Insurance CommissionerOverviewThe Office of the Insurance Commissioner (OIC) is a fairly small Washington stateagency. It runs under the direction of the Insurance Commissioner, a statewideelected official. Unlike most state agencies, we don’t receive public tax dollars.Insurance companies pay an administrative fee to cover all of our costs.The OIC employs about 220 people who support the agency’s mission ofconsumer protection and insurance industry regulation from central officeslocated in Olympia, Tumwater and Seattle with a satellite office in Spokane. TheOIC considers the over 400 SHIBA volunteers, 20 SHIBA sponsoring organizations*and their staff as part of the OIC family.*Sponsoring organizations are local community organizations that contract withthe Office of Insurance Commissioner to support its mission to provide free,unbiased information about health care coverage and access to help improve thelives of all Washington state residents. Sponsors will provide staff and/orvolunteers to educate residents about their healthcare options, evaluate andcompare Medicare insurance plans, and make public presentations.RoleThe OIC regulates insurance business in Washington state under authority fromstate insurance laws.Consumer protection is the most important job of the Insurance Commissioner.During 2019, the OIC investigated and resolved more than 6,000 complaints,recovering almost 14 million for consumers. The Insurance Commissioner alsocoordinates many protective and assistance services for insurance consumers.Staff in the Consumer Protection Division, which is where SHIBA resides, respondto thousands of questions from consumers every year.The Insurance Consumer Hotline is a toll-free line consumers can call for help withall issues related to insurance. Calls are triaged and sent to either our complianceanalysts or SHIBA. Our compliance analysts help with insurance issues, plans andcompanies that the OIC regulates. When insurance issues are outside OIC’sSHIBA volunteer handbook Updated October 2020 Page 10

control (such as issues regulated by federal law), staff refer consumers toappropriate resources. In 2019, the Insurance Consumer Hotline received callsfrom more than 62,000 consumers and conducted more than 3,800 live chatsessions.SHIBA assists consumers with all kinds of health insurance, but mainly Medicarerelated plans such as prescription drug plans, Medigap plans, public programs andfraud and abuse.We’re proud of the work we do at the OIC and we’re glad you're part of our team!Office of the Insurance CommissionerOrganization on UnitRates and FormsConsumerProtectionOperationsLegal AffairsPublic AffairsPolicy andLegislative AffairsSHIBAConsumer Protection (CP) Division – SHIBASHIBA volunteer handbook Updated October 2020 Page 11

DeputyCommissionerAdministrativeAssistantSHIBA ProgramManagerCommunicationsConsultantField OperationsSupervisorRegional TrainingConsultants inatorAdministrativeAssistantTraining orSecretary SeniorAbout State Health Insurance AssistancePrograms and SHIBASHIPsThe State Health Insurance Assistance Programs (SHIPs) provide free, in depth,one-on-one insurance counseling and assistance to Medicare beneficiaries, theirfamilies, friends and caregivers. SHIBA is the SHIP program for Washington state.SHIPs operate in all 50 states, the District of Columbia, Guam, Puerto Rico and theU.S. Virgin Islands, and are grant-funded projects of the federal U.S. Departmentof Health and Human Services (HHS) and the U.S. Administration for CommunityLiving (ACL). For more information visit www.acl.gov or www.shiptacenter.org.SHIBA mission statementSHIBA provides free, unbiased information about health care coverage and accessto help improve the lives of all Washington state residents. We cultivatecommunity commitment through partnership, service and volunteering.SHIBA volunteer handbook Updated October 2020 Page 12

Who we are SHIBA is part of the Consumer Protection Division within the OIC. We’re a free health care access and information resource. We provide information and counseling services to help consumers evaluate,plan for their needs, and use health insurance—mainly Medicare—and publichealth programs.SHIBA is an education and referral system of: Community volunteers Local sponsoring agencies OIC staff Other government agencies and community partnersSHIBA history In operation since 1979Started by a volunteer in Skagit CountyThe first program of its kind in the nationRecognized nationally as a model for health insurance consumer counselingInspired federal funding to create SHIPs in all statesTwenty local sponsoring agencies represent all 39 Washington countiesSHIBA servicesFeatures and benefits FREE! Impartial and objective (no affiliation with any insurance company orproduct) Confidential Accessible offices in nearly every countyWays we can help Assess health care coverage needs Assist Medicare beneficiaries to protect from Medicare fraud Screen for possible eligibility for programs Evaluate and compare policies and programs Identify and report possible fraud Provide referrals to other agencies and programsSHIBA volunteer handbook Updated October 2020 Page 13

Methods and activities One-on-one counseling Public presentations and workshops Health fairs and special events Publications and online resources Referrals Community partnership development Recruiting and training volunteers Continuing educationWho SHIBA serves People of all ages, all walks of life People with disabilities Seniors and pre-retirees Ethnic populations LEP (Limited English Proficiency) communities Disease-specific groups Uninsured people Rural populations People of all economic backgroundsSHIBA staff and resourcesWe’re here to help! Following is information on how to reach our office. Pleasework with your volunteer coordinator or regional training consultant if you havequestions about staff, resources or SHIBA operations. A current staff contact list isposted on My SHIBA at: www.insurance.wa.gov/my-shiba.SHIBA reception . 360-725-7073Insurance Consumer Hotline. 800-562-6900Visit or call between 8 a.m. and 5 p.m., Monday to Friday.Email: shiba@oic.wa.govMailing address:P.O. Box 40255Olympia, WA 98504-0255Street address:5000 Capitol Blvd. SETumwater, WA 98501SHIBA volunteer handbook Updated October 2020 Page 14

SHIBA staff contactsFor a full SHIBA staff list and their job duties, go to My SHIBA at:www.insurance.wa.gov/my-shiba and search for “SHIBA staff contact list.”Senior Medicare PatrolThe Senior Medicare Patrol (SMP) is a federal program that funds SHIBA to be theWashington state SMP to educate consumers, caregivers and families aboutMedicare fraud, abuse and errors.The SMP mission: Senior Medicare Patrols (SMPs) empower and assist people onMedicare, their families and caregivers to prevent, detect and report health carefraud, errors and abuse.For information, go to: www.smpresource.org.Prevent, detect, reportKnowing what fraud and abuse are—and the difference between the two—iscrucial, and educating people is critical to SHIBA’s mission. As SHIBA volunteeradvisors, we’re more effective is we can help clients understand what afraudulent activity is. We may need to counsel and educate clients around howthe health care system and billing works, and how to read Medicare summarynotices.Volunteer Risk Program Management (VRPM) Policies andworking with the Administration for Community Living (ACL)SHIPs rely on volunteers to serve Medicare beneficiaries within their sta

SHIBA . volunteer handbook . Insurance Consumer Hotline: (800) 562-6900 . Administrative Office: (360) 725-7073 . PO Box 40255 . Olympia, WA. 98504-0255

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If you have any questions about the guide or an insurance issue, please call our Insurance Consumer Hotline toll-free at 1-800-562-6900 or e-mail me at . AskMike@oic.wa.gov. We're here to help you. Sincerely, Mike Kreidler . Washington State Insurance Commissioner

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