Form CMS-10494 Training Quality Questionnaire

Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel -CAC (CMS-10494)

CMS-10494 - Appendix F_Training Quality Questionnaire

155.225(d)(1) and (7) Training Quality Optional Questionnaire

OMB: 0938-1205

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MLMS Assister Training Feedback
N/A
Training Content

1. The scope of the material is
appropriate to my needs.
2. The content will help me use
HealthCare.gov to assist
consumers with the eligibility
and enrollment process.
3. The content has given me
sufficient information to perform
the following tasks on the job:
a. Adequately explain
health insurance
concepts and educate
consumers about the
different types of plans
available to them
b. Assist consumers with
creating an online
Marketplace account
c. Use the Plan Compare
Tool to help consumers
learn about and
compare coverage
options
d. Conduct effective
outreach in the
communities I serve and
build community
partnerships
e. Help consumers
understand SHOP
Marketplace policy (e.g.,
employer and employee
eligibility, application
requirements, the
appeals process)
4. The content has given me
sufficient information to assist
consumers with these more
complex scenarios:
a. Assist consumers in
multi-tax households

Disagree

Neutral

Agree

(1)

Strongly
Disagree
(2)

(3)

(4)

(5)

Strongly
Agree
(6)

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

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5☐

6☐

1☐

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1☐

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1☐

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5☐

6☐

N/A
Training Content

5.

6.

7.

8.

9.

10.

b. Assist consumers
applying for exemptions
c. Assist consumers in
households with mixed
immigration statuses
d. Assist small employers
understand the Small
Business Health Care
Tax Credit
e. Assist employees
understand how to
obtain coverage
through the SHOP
Marketplace
The content has given me
sufficient information to assist
consumers with multi-tax
households.
The content has given me
sufficient information to assist
consumers with applying for
exemptions.
The content has given me
sufficient information to assist
consumers within households
with mixed immigration
statuses.
The content has given me
sufficient information to assist
consumers with help small
employers understand the Small
Business Health Care Tax Credit.
The content has given me
sufficient information to assist
consumers with helping
employees understand how to
obtain coverage through the
SHOP Marketplace.
The content has given me
sufficient information to work
with the following population:
consumers with disabilities.

Disagree

Neutral

Agree

(1)

Strongly
Disagree
(2)

(3)

(4)

(5)

Strongly
Agree
(6)

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

N/A
Training Content

11. The content has given me
sufficient information to work
with the following population:
immigrants.
12. The content has given me
sufficient information to work
with the following populations:
consumers with limited English
proficiency.
13. The content has given me
sufficient information to work
with the following populations:
American Indians/Alaskan
Natives.
14. The content has given me
sufficient information to work
with the following populations:
Medicare-eligible consumers.
15. The content has given me
sufficient information to work
with the following populations:
Medicaid/CHIP-eligible
consumers.
16. The content has given me
sufficient information to work
with the following populations:
Tri-Care eligible consumers.
17. The content has given me
sufficient information to work
with the following populations:
consumers under age 26.
Training Structure

18. Please rank in order of
importance the following
training features by how useful
they are in helping you
understand the material during
the training:
a. Screenshots of
HealthCare.gov.

Disagree

Neutral

Agree

(1)

Strongly
Disagree
(2)

(3)

(4)

(5)

Strongly
Agree
(6)

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

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6☐

1☐

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3☐

4☐

5☐

6☐

1☐

2☐

3☐

4☐

5☐

6☐

1 - 1st

2 - Second

3 - Third

4 - Fourth

a.☐

a.☐

a.☐

a.☐

b.☐

b.☐

b.☐

b.☐

c.☐

c.☐

c.☐

c.☐

d.☐

d.☐

d.☐

d.☐

5 - Fifth

n/a

6 - Sixth

n/a

N/A
Training Content

b. Detailed
scenarios/narratives of
enrollment situations.
c. The ability to print and
read materials during
the training.
d. Hands-on, interactive
exercises or content.
19. Please rank in order of
importance the following
training features by how useful
they are in helping you
understand the material after
the training:
a. Real-time help with
complex consumer
scenarios
b. Specific examples of how
to assist consumers with
complex scenarios
and/or Continuing
education webinars
c. Fact sheets, FAQs, and
other printed materials
d. Standard operating
procedures
e. Examples of best
practices from other
assisters
f. More in-depth assister
certification training

Disagree

Neutral

Agree

(1)

Strongly
Disagree
(2)

(3)

(4)

(5)

Strongly
Agree
(6)

a.☐

a.☐

a.☐

a.☐

a.☐

a.☐

b.☐

b.☐

b.☐

b.☐

b.☐

b.☐

c.☐

c.☐

c.☐

c.☐

c.☐

c.☐

d.☐

d.☐

d.☐

d.☐

d.☐

d.☐

e.☐

e.☐

e.☐

e.☐

e.☐

e.☐

f.☐

f.☐

f.☐

f.☐

f.☐

f.☐

Tell Us What You Think?

Please use the space below to answer the following question:
What other information would you have liked to see included in the training?”

Type response here:


File Typeapplication/pdf
File TitleMLMS Assister Training Feedback
SubjectMarketplace Learning Management System, MLMS, Training Feedback, assister
AuthorCMS
File Modified2015-04-02
File Created2015-04-02

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