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Language Access in Insurance: Helping LEP Consumers Get Access to the Marketplace

Health insurance is a necessity for every person living in the United States. The Affordable Health Care Act allowed more uninsured people to get covered. According to the U.S. Census Bureau, 91.2 percent of Americans had health insurance in 2017. Still, 28.5 million residents didn't have health coverage during the year.

Insurance shields policyholders from the rising costs of prescription medicines, hospital stays, and doctors visits. This essential coverage also provides preventative care for patients' medical conditions. Sadly, some individuals with limited English proficiency (LEP) don't buy health plans because they can't speak English or read the insurance documentation.

The uninsured rates for LEP persons are higher according to a Robert Wood Johnson Foundation study. The organization's State Health Access Data Assistance Center followed how many people with limited English proficiency had coverage. They discovered:

  • LEP persons comprised 8.6 percent of the American population in 2014.
  • The group found 21.7 percent of LEP individuals were uninsured that year.
  • Almost 4.5 percent of these individuals had employer insurance coverage.
  • Five percent of LEP people purchased health insurance directly.
  • Twelve percent got Medicaid assistance.
  • Approximately 7.7 percent received Medicare.

According to the RWJ Foundation, these individuals prefer to learn about health care services in languages other than English. Usually, LEP persons don't get enough information in their native language to help them enroll in insurance plans. When businesses provide interpreters to LEP customers, it improves customer satisfaction, quality of care, and health outcomes.

Insurance companies that offer interpretation services to LEP persons can tap into a flourishing consumer market. These translation services can also help these customers to understand their healthcare coverage and to pay premiums. In today's Language Network USA guide, you'll learn comprehensive strategies to implement translation services at your business.


Who are Persons with Limited English Proficiency in America?

In 2014, the U.S. Census Bureau published a study called the "English-Speaking Ability of the Foreign-Born Population in the United States:  2012." They examined English language proficiency among foreign-born people. The U.S. Census Bureau defines "foreign-born" as any person who isn't an American citizen at birth. They include the following individuals:

  • Naturalized U.S. citizen
  • Lawful permanent residents (immigrants)
  • Temporary migrants
  • Humanitarian migrants (refugees and asylum seekers)
  • Persons illegally in the U.S.

In its American Community Study, federal researchers focused on the relationship between foreign-born citizens' English speaking ability, educational level, birthplace, and years spent living in the U.S. The study found that the size of the foreign-born population has increased since 14.1 million in 1980 to 40.8 million at the time of the most recent U.S. Census in 2010. The survey found that the proportion of foreign-born persons that spoke a language other than English at home increased since 1980.

  • In 1980, 70 percent of foreign-born people 5 years and older spoke languages (other than English) at home.
  • In 2010, eighty-five percentage of foreign-born persons spoke their native languages at home.
  • Foreign-born individuals who spoke their primary language at home remained steady at 85 percent in 2012.
  • The study found nine in ten foreign-born Californian, Illinois, and Texan residents spoke their native languages at home.

Researchers also found that English isn't the native language of most immigrants unless they lived in English-speaking nations. Some foreign-born persons may become fluent in English after residing in the country for many years. Others may never speak the language well at all, even after decades of living in the U.S.

Why should insurers pay attention to these statistics? According to the Families USA and the National Health Law Program, one in four consumers eligible to enroll in the health care marketplace speaks languages other than English. Insurance companies must address language barriers to provide customers with equal access.


Federal Law Requires Insurers to Provide Access to LEP Persons

The Civil Rights Act of 1964 prohibits discrimination on the basis of race, color, and national origin under its Title VI clause. All organizations that receive federal assistance must comply with the law or lose funding. According to the federal government, national origin discrimination includes the failure to provide meaningful access to LEP persons. Under the statute, medical professionals must provide interpretation and translation services so LEP patients can have equal access to health care services.

The U.S. Department of Health and Human Services requires insurers to follow Section 1557 of the Affordable Care Act of 2010. This civil rights provision prohibits discrimination based on race, color, national origin, sex, age, and disability in health programs and activities. The federal agency requires companies to provide the following protections to LEP persons.

  1. Companies must provide reasonable access to every LEP individual their business serves or may encounter.
  2. Insurers must provide access to languages assistance services. These include oral language assistance and written translation.
  3. Insurance and health care companies should post a notice of individual rights. This document provides information about interpretation assistance for persons with limited English proficiency.
  4. States must include taglines in the top 15 languages spoken by persons with limited English proficiency. These local agencies must give information about communication assistance services.
  5. The agency encourages covered entities to develop and deploy a language access plan to serve LEP people who need assistance.


How Insurers May Conduct Bad Faith When Serving LEP Populations

Another area that insurers must address involves communicating with LEP policyholders. In California, insurance providers must make good faith efforts to pay legitimate claims. Under state law, insurers must do the following:

  • Provide coverage to policyholders.
  • Uphold the contract's terms.
  • Pay valid claims as outlined in the policy.
  • Conduct an adequate claims investigation to find out who is liable.
  • Offer policyholders a clear defense against third-party claims.

Insurers can be liable for bad faith practices if they use deceptive methods to avoid paying valid claims. Bad faith insurance actions involve companies that:

  • Refuse to pay claims without adequate investigation.
  • Fail to process claims within a reasonable time.
  • Refuse to pay or deny claims.
  • Offers lower settlements than claimants can collect under their policies.
  • Don't explain the reasons why the insurer denied a claim.
  • Fails to enter into settlement negotiations.
  • Refuse to respond or process claims quickly.
  • Fail to disclose the policy's coverage limits.
  • Refuse to give policy statements about coverage.

Insurers may commit bad faith if they don't provide LEP policyholders with interpreters or translated materials to understand their coverage. Additionally, insurance companies should offer translation services when investigating claim-related matters. Businesses who don't follow the Affordable Care Act's Section 1557 may be liable under the law.


A Checklist to Help Insurers Implement Language Assistance Programs

Families USA and the National Health Law Program have developed a Language Access Checklist for Marketplace Implementation. This document helps insurers design marketplaces that comply with federal laws.

Companies should conduct an assessment to identify the needs of their LEP populations. This audit should identify the most common languages spoken in their area. Next, establish a health disparities committee to identify and address linguistic and cultural problems within your marketplace. Third, create a language action plan (LAP) that implements the communication needs of LEP consumers in policies, contract, and marketplace documentation.

Your business should identify an outside contractor, like Language Network USA, that provides bilingual and bicultural assistance to these populations. These include navigators, certified application counselors, and advisers.

Insurers can use the tips below to implement language assistance services at their companies. For a full list of LEP strategies, visit this page.


1. Providing LEP Persons with Language Access in Enrollment Assistance Program

You should require these contractors to provide your business with the following:

  • They should have a comprehensive plan to service LEP populations as part of grant submissions, contracting, and registration processes.
  • Their organization must reach and serve all appropriate LEP populations in the state.
  • Companies must provide training on assessing LEP population's language needs. They should acquire interpretation services and work with interpreters for navigators, certified application counselors, and certified marketplace insurance brokers.
  • Translate all outreach materials into the 15 most common languages used by local LEP persons.
  • Partner with local health organizations and workers who serve LEP persons. They should help with your company's outreach and enrollment assistance plans.
  • Institute a formal method to collect feedback from LEP customers. Obtain suggestions from navigator and consumer assistance programs to help address systemic problems when serving LEP consumers.
  • Collect and release all data on the number of interactions your company had with LEP persons, the languages they spoke, and the use of the language service.


2. Developing Online and Paper Insurance Applications for LEP persons

  • Translate all paper and online applications into the state's most common languages.
  • Organizations must provide direct access to translated versions of online applications on enrollment portals and marketplace websites.
  • Insurers must include taglines in at least 15 languages. These tell LEP persons how to obtain in-person or call center assistance with their applications. Post this information on the online application website.
  • Companies must provide easy access to translated paper applications. The document should tell LEP person how to get foreign language versions. Providers must offer at least 15 translations in the application's instructions.
  • Insurers must provide materials that LEP persons request materials in their preferred languages. They must list direction on paper and online applications. Companies should provide this information to LEP applicants, household members, authorized representatives. Companies must send communications in every language indicated.

Language Network USA has a document translation service to translate reports, investigations, and consumer flyers into your customers' preferred languages.


3. Implementing Translation Services at Call Centers

  • Federal civil rights laws require insurers to provide consumers with limited English proficiency (LEP) with access to language services.
  • Companies should conduct a needs assessment to identify target LEP populations.
  • Insurers must hire bilingual consumer service representatives for their marketplace call centers. These workers must speak foreign languages common to their geographical area.
  • Insurance companies should provide access to licensed interpreters at all times.
  • Businesses should train call center personnel on how to engage with LEP callers. They must know how to contact bilingual staff or interpreters. The professionals should refer customers to consumer assistance programs and in-person enrollment assistance.
  • Insurers must help LEP persons gain access to bilingual representatives and interpretation services. Companies should record translated voice prompts and directions for automated systems. If possible, provide a direct line for in-language assistance programs.
  • Companies must collect and report the number of LEP consumer calls they received and the languages consumers speak. They should also document their clients' use of language services.

Language Network USA can provide 4,000 qualified interpreters across California to provide over-the-phone interpreting.

4. LEP Services on Marketplace Website

  • Companies should translate all marketplace websites into Spanish and two other languages.
  • They should include taglines on your marketplace's homepage in the state's top 15 languages to inform your LEP customers about the availability of written translations, language services, and additional assistance.
  • Provide a link to a directory of consumer assistance programs on the marketplace's home page where customers can search for assistance in their native language.

5. Outreach and Education

  • Create outreach and educational plans that are culturally appropriate. Insurers should tailor each one to LEP populations, especially groups affected by health disparities.
  • Develop and implement outreach plans with trusted community-based organizations and messengers that work with LEP populations.


Hire Language Network to Handle Your Insurance Company's Translation Needs

Insurance agencies must offer services for a more diverse clientele. Today's consumers speak a variety of languages. Insurers need interpreters to communicate accurately with their clients. You can learn more how we help insurance companies and adjusters here.

Language Network is a professional translation service that can help communicate with your customers that have limited English proficiency (LEP). The insurance industry has trusted our company to conduct business across the language barrier for more than 27 years.

Major insurance companies have relied on our services including Allstate, National General Insurance, Nationwide, and The Hartford.

Our company provides on-site interpretations for:

  • Legal meetings
  • Investigative meetings
  • Medical meetings
  • Customer consultations

We also translate:

  • Reports
  • Investigation documents
  • Information flyers
  • Website documents

Trust Language Network to handle your translation-related needs. Language access is our mission. Request a free quote from us today.




About Language Network

Language Network is a language solutions company specializing in interpretation, translation, and localization services for government, healthcare, and international businesses. Language Network provides critical language access and support in over 200 languages. For more information, visit www.languagenetworkusa.com.

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