Optimized language services eliminate language barriers during open enrollment and create a better experience for your limited-English proficient (LEP) enrollees. Health plan interpretation services and translated materials aren’t just a compliance checkbox — they’re often the difference between an enrollee who understands their coverage and one who doesn’t. Here are three steps you can take to improve the language services your health plan offers during open enrollment and throughout the year.
Step 1: Determine which language services you’ll need
To comply with Section 1557 of the Affordable Care Act, you must provide interpretation and translated documents for enrollees who speak languages other than English. Exchanges, qualified health plans, and web brokers registered for more than one year must meet several requirements under the ACA:
- Free language access: Entities must provide oral and written translation services as needed by applicants and customers, at no additional cost.
- Notice of Availability requirements: Covered entities must post an annual Notice of Nondiscrimination and a separate Notice of Availability of language assistance services in English, and the top 15 non-English languages spoken in the state or states where they operate. This Notice of Availability requirement replaced the short “tagline” statements that earlier versions of Section 1557 required.
- Website accessibility: Website content must be translated into languages spoken by LEP groups that make up 10% or more of a relevant state’s population. Qualified health plans only need to translate “critical” information. Exchanges and web brokers, however, must translate all web content intended for qualified individuals, applications, employers, employees, and enrollees.
- Targeted member communications: Health plans must also provide the Notice of Availability alongside claims, appeals, and summaries of benefits in any non-English language spoken by 10% or more of the population in any county they serve.
Optimizing interpretation services for health plans
To optimize your interpretation offerings, look closely at how you currently communicate with LEP enrollees:
- Do you offer over-the-phone interpretation or one-on-one video calls to answer enrollee questions?
- Do you host teleconferences or webinar information sessions in the languages your enrollees speak?
- Can enrollees reach a professional interpreter quickly, without long hold times or repeated transfers?
- Are you utilizing reporting and analytics tools to understand scale, track demand, and measure language utilization across touchpoints?
If you identify gaps during this review, map out where additional language support is needed across your member touchpoints. Evaluate whether your current internal capacity and vendor resources can support those needs, especially when demand surges during peak enrollment periods.
Optimizing translation services for health plans
While certain ACA rules specify minimum thresholds, many health plans carry distinct legal obligations to provide translated materials—some on a standing basis and others on an as-needed basis. Beyond mandatory requirements, health plans should assess each member document by asking:
- Could an LEP person reasonably participate in this health plan without this information?
- Could an LEP person’s benefits or claims be denied if they don’t understand this document?
- Could an LEP person suffer significant financial, physical, or other harm without understanding the information?
If the answer to any of these is yes, that document belongs on your translation priority list, even when the ACA doesn’t strictly require it.
Step 2: Select a qualified language services provider
Choosing a language services provider for a healthcare organization means finding an LSP that can fulfill your interpretation and translation needs while delivering consistently high-quality services. As you evaluate providers, ask about:
- Superior customer service: How does the LSP train interpreters to deliver excellent customer service?
- Subject matter expertise: Do the LSP’s interpreters and translators understand the nuanced terminology used in the health insurance industry?
- HIPAA compliance and data security: How will the LSP protect your enrollees’ private health information and your health plan’s proprietary data?
- Third-party accreditation: Can the LSP consistently meet objective quality standards for the services it provides?
- Account support: Does the LSP provide a dedicated account manager and translation project manager to answer your team’s questions?
- Guided implementation: Will your team be expected to set up its own equipment and services, or will experts guide you through the process?
A strong LSP should be able to answer each of these questions clearly and back up its answers with real examples from other health plans it supports.
Step 3: Prepare for open enrollment
With a list of necessary language services and a qualified provider ready to help, here’s how to prepare for open enrollment:
Translate key documents into your state’s top 15 languages, including:
- Enrollment materials: explanation of coverage, annual notice of change, directories, formularies, and welcome materials
- Member correspondence: explanation of benefits, claim supporting documentation, grievances and appeals, and utilization management
- Marketing materials: website and app content, summary of benefits coverage, and promotional materials such as brochures
Train your enrollee support staff to use remote interpretation services, including:
- Providing training and written instructions on how to access an interpreter
- Making it easy for staff to remember account login information using access badges, stickers, or other tools
- Giving LEP enrollees unique toll-free numbers that connect them to your staff with an interpreter already on the line
For a deeper look at building a multilingual communication strategy for this season, check out Propio’s guide, How to Keep Multilingual ACA Members Informed During Open Enrollment. It walks through many of these same steps in more detail, with examples you can apply to your own open enrollment planning.
