Client Resources – Page 4 – Charlotte Center for Legal Advocacy

Wage Theft During the Holiday Season

Posted on December 10, 2021

The holiday season is busy and stressful for many workers, especially hourly workers in the retail, food service, and delivery sectors. During this busy time, employers are less likely to pay workers for all hours worked or to pay overtime rates. It is important for workers to understand common practices that result in unpaid wages and incorrect hourly rates, also referred to as wage theft.

What to look out for

According to the US Department of Labor, common employment law violations during the holiday season include:

Misclassifying employees as independent contractors to evade liability under employment laws
Failing to pay salespeople and cashiers for time spent prepping or closing out registers
Requiring stock room and warehouse workers to work through breaks without pay
Requiring workers to clean or perform closing duties after they have clocked out
Failing to pay promised holiday rates or overtime rates

Who is at risk

Temporary holiday and seasonal workers are particularly vulnerable to wage theft. Employers count on these temporary workers to be unfamiliar with their employment rights and too busy to keep careful track of hours worked. Many temporary or seasonal workers are hired through subcontracted companies or temporary staffing firms, making it even more difficult to track down unpaid wages after the holiday rush is over.

What to do

If you think that your employer isn’t paying you proper wages for all hours worked, it is important to keep records of your pay and hours. Make sure to keep any records of agreed upon pay rates, paystubs, and actual hours worked. It is also a good idea to keep records of any communication with your employer, manager, or supervisor regarding your schedule, hours worked, and pay rates. Pay close attention to any differences between promised overtime or holiday pay and the amount you are actually paid.

The US Department of Labor has a free smartphone app to help workers track their hours.

Learn more

You can learn more about your workplace rights in North Carolina by calling the North Carolina Department of Labor’s Wage and Hour Bureau at 1-800-625-2267 (1-800-NC-LABOR). You can also file a Wage Complaint with the Wage and Hour Bureau; more information is available on the NCDOL website.

If you would like to discuss possible unpaid wages, call us at 704-376-1600.

Open Enrollment 2021: FAQ Videos

Posted on October 27, 2021

Open Enrollment for the Health Insurance Marketplace (AKA Healthcare.gov) will open Nov. 1, 2021, and last until Jan. 15, 2022.

Our federally trained Navigators answer your top health care coverage questions and share important information on where to find help during this year’s Open Enrollment. Siga el enlace para videos en español.

Frequently Asked Questions

Let’s go over some Open Enrollment vocabulary: ACA, Obamacare, Healthcare.gov, Marketplace

What are the benefits of health care coverage from the Marketplace?

Who qualifies for health care coverage, how do you apply, & why do you need to re-enroll?

What programs are available to help people pay for health care?

What is the Medicaid gap or coverage gap? What are some resources for people in the Medicaid gap?

What are the rules on health care coverage for immigrants?

Where can I get help learning about health care coverage and how to enroll?

Preguntas frecuentes en español

Revisemos algunos conceptos importantes sobre el período de inscripción abierta: ACA, Obamacare, Mercado de seguros y www.cuidadodesalud.gov

¿Cuáles son los beneficios de obtener Seguro de salud en el Mercado de Salud?

¿Quiénes califican para Seguro médico, cómo aplicar y por qué necesita reinscribirse?

¿Qué programas de asistencia financiera están disponibles para asistencia de Seguro médico?

¿Qué es el gap de cobertura de Medicaid?¿Cuáles son las opciones para las personas en el gap de cobertura de Medicaid?

¿Cuáles son las reglas para que los inmigrantes puedan acceder a Seguro de salud?

¿Dónde puedo encontrar más ayuda disponible sobre temas de Seguro de salud?

Basic Health Insurance Terms

Posted on October 26, 2021

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

GET COVERED

There are a lot of special terms in the health insurance world, and they can be difficult to understand. We’re here to help you make sense of terms you see on Healthcare.gov.

Watch the video and scroll down for more terms defined.

Learn more about how to get covered, or call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

Catastrophic Health Plan
The premium amount you pay each month for healthcare is generally lower than for other plans, but the out-of-pocket costs for deductibles, copayments and coinsurance (see terms defined below) are generally higher. To qualify for a Catastrophic plan, you must be under 30 years old OR get a “hardship exemption” or “affordability exemption” (the Marketplace determines that you are unable to afford health coverage because of the cost of the health insurance plan offered to you is too expensive or you have a financial hardship circumstance).

COBRA
A federal law that may allow you to temporarily keep health coverage after your employment ends. If you choose COBRA coverage, you pay 100% of the premiums, including the portion that your employer used to pay, plus a small administrative fee.

Coinsurance
Like a copayment (see next term), but in the form of a percentage of the cost of a healthcare service (e.g. you pay 20% of the cost of a visit or procedure).

Copayment
A set amount that you pay for a medical service or item, like a doctor’s visit. The insurance company covers the rest.

Deductible
The amount you have to pay for covered health care services (e.g. doctor and hospital visits, labs, etc.) before your health insurance or plan begins to pay. Often, the health insurance company will only pay a percentage of the costs after you reach your deductible. If you think you will need a lot of healthcare services in a year, you should look for plans with a low deductible.

Metal Categories of Health Plans
In addition to catastrophic plans, Healthcare.gov plans come in four metal categories: Bronze, Silver, Gold and Platinum. Bronze plans are usually best for individuals who have few health needs but want to be prepared in case of an emergency. Bronze plans have the lowest monthly premiums, but they have a high deductible. Gold and Platinum plans are often best for people who use a lot of health services. They have the highest monthly premiums, but each visit to the doctor and each prescription will have a low copay/coinsurance. Plans in all metal categories provide free preventive care (for example, a yearly wellness visit to your doctor).

Silver plans are ideal for individuals/families with income less than 250% FPL. If you select a Silver plan, you will receive cost sharing reductions, which means your out of pocket costs (deductible, coinsurance and copays) are also subsidized and may be very low.

Network
The doctors, hospitals and suppliers your health insurer has contracted with to deliver health care services to their members. Ask a healthcare provider if they accept your insurance before you visit. If you go out of network, your care will be more expensive.

Out-of-pocket Maximum
Usually a larger number than your deductible. This is the absolute maximum amount of money you will have to spend in the year on healthcare costs. After you reach this amount, the health insurance company will cover all services 100%.

Plans and Prices Tool: https://www.healthcare.gov/see-plans/#/
Saves you time! This tool allows you to see what plans are available in your area and how much financial assistance you qualify for before you fill out an application.

Pre-existing Conditions
A health problem, like asthma, diabetes, or cancer, that you had before the date that new health coverage starts. Insurance companies can’t refuse to cover treatment for your pre-existing condition or charge you more.

Premium
The amount you pay for your plan each month.

Premium Tax Credit
The “subsidies” that lower the cost of your monthly premiums. You can take the premium tax credits in advance to lower your monthly cost, or you can take them as a refund at tax time.

To look up more key terms, visit the Healthcare.gov glossary.

NC Medicaid Managed Care – FAQs

Posted on October 12, 2021

North Carolina Medicaid Managed Care- What is it and how does it affect my Medicaid coverage?

North Carolina has undergone a change in how Medicaid benefits are set-up. This change, called the Medicaid Transformation, has caused many Medicaid-eligible individuals to be switched from the traditional Medicaid Direct, managed by the state of North Carolina, to new health plans that are managed by private companies instead. This change took place officially July 1, 2021, but many people are still left with questions about how the changes affect them. Answers to some common questions are below, as well as guidance on where to go for help.

Am I still eligible for Medicaid?

While the way benefits and services are managed has changed, Medicaid eligibility criteria are the same under the new Managed Care system. If you want to report changes to your situation (address, income, etc.) or if you want to apply for Medicaid, you will still need to contact your local Department of Social Services (DSS) office.

Am I enrolled in one of the new Medicaid health plans?

You may have selected a Prepaid Health Plan (plan or PHP) to manage your health care, either during the enrollment period or when you applied for Medicaid. If you didn’t select a plan, you may have been automatically enrolled in one. If you were automatically enrolled in a health plan, you should have received a packet from your health plan with a new Medicaid card. If you are not sure which plan you are in, or if you have not received a card form you plan, you can call the Enrollment Broker at 833-870-5500 (TTY: 833-870-5588).

Where can I learn about the health plan benefits?

You can learn about the plans below and online.

What if I want to switch to a different Medicaid plan?

You have 90 days after coverage under your new Managed Care health plan begins to change to a different health plan for any reason. For beneficiaries whose coverage began July 1, this choice period ended September 30. However, you can still switch to a different health plan after this choice period if you have a special reason to do so, If you want to request to switch to a different plan, call the Enrollment Broker at 833-870-5500 (TTY: 833-870-5588) or submit the Health Plan Change Request form, found here.

If you have any problems or unanswered questions, the NC Medicaid Ombudsman is a resource to answer questions and help resolve issues about the move to Medicaid Managed Care. You can reach them at 877-201-3750 from 8 a.m. to 5 p.m. Monday through Friday, except State holidays, or you can visit their website at ncmedicaidombudsman.org.

How do I use my new Medicaid card?

Providers should NOT require you to show your physical Medicaid ID card in order to see you at your appointment.

What if some of my doctors don’t accept the new Medicaid plan?

Each health plan has a group of providers called a network, and you’ll usually have to go to providers in your plan’s network. We recommend you confirm with your medical providers that they are in network with your health plan, and call your plan if you have any questions about what services you can receive and what providers you can see. If your provider has not contracted with your health plank, so they are not in your plan’s network, you may have to see another provider who does accept your plan. However, depending on your situation, you may be able to switch to a different plan to continue seeing your provider. You can contact the Enrollment Broker at 833-870-5500 (TTY: 833-870-5588) or submit the Health Plan Change Request Form to make this request.

What about my dental and vision coverage?

Some services are not covered through your new health plan and will continue to be covered through NC Medicaid Direct (traditional Medicaid). These services are known as “carved out” services, and include dental services and the fabrication of eyeglasses (however other vision services are managed by your health plan). For these carved out services, you can see any provider who accepts Medicaid, rather than only providers in your health plan’s network.

How do I schedule transportation to my appointments under the new system?

If you are enrolled in one of the new Medicaid Managed Care health plans, you will need to call your health plan to schedule a ride to and from your appointments. If you stayed in NC Medicaid Direct, you can still arrange transportation through your local DSS office. If you have problems with your transportation arrangements, you should report these issues to the NC Medicaid Ombudsman.

What if I have special health care needs?

Many people who were receiving services for severe behavioral health needs or intellectual/developmental disabilities before Medicaid transitioned to Managed Care were not required to enroll in a new Medicaid Managed Care health plan, and remained in NC Medicaid Direct. If you need services to address serious mental illness, serious emotional disturbance, severe substance use disorder, intellectual/developmental disability or traumatic brain injury, but you have been enrolled in a new Medicaid Managed Care health plan, you can reach out to the NC Medicaid Ombudsman to learn more about what your options are to ensure you get the services you need.

I have other questions about the new system, where can I go?

The NC Medicaid Ombudsman is a third party resource designed to help people through the transition to Medicaid Managed Care and to help them use their Medicaid coverage to get the services they need. The NC Medicaid Ombudsman can answer many questions and connect you to helpful resources. They can be reached toll-free at 877-201-3750, 8 a.m. to 5 p.m., Monday through Friday, except State holidays. Or you can visit them online at ncmedicaidombudsman.org.

NAVIGATING OPEN ENROLLMENT: Healthcare.gov Income Questions

Posted on October 2, 2021

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

GET COVERED

Charlotte Center for Legal Advocacy’s health insurance navigators help families and individuals choose plans that are best for them within the Health Insurance Marketplace implemented under the Affordable Care Act (ACA). During this Open Enrollment Period, navigators have received calls and questions from Cabarrus, Mecklenburg and Union County residents about the household income section of the Healthcare.gov application. With this year’s pandemic and economic uncertainty, many have lost or changed employment and are struggling to estimate their income.

Listed below this video are some helpful tips and general guidelines. More of what to (and not to) include is available at charlottelegaladvocacy.org/getcovered.

Important points:

You must estimate your projected income for the upcoming year.
- If you are unemployed, it may be difficult to do this. Estimate how much you would make if you returned to your previous job.
- If you don’t have a set salary or wages (for example, if you are a freelance worker, seasonal worker, or run your own business), it will be easier to estimate your income if you have a copy of your tax return from last year on hand.
- If you are self-employed, you should input your net income. Click here for more help estimating your self-employment income.
- If your income is very low or if you are unemployed, and you or a family member falls into one of the following groups, you may qualify to receive Medicaid:
  - children under 21
  - pregnant women
  - women with breast or cervical cancer
  - primary caretaker of a child under 18
  - individual in foster care when turned 18
  - individuals aged 65 or older
  - blind or disabled individuals
  - people in need of long-term care
  - people receiving Medicare
You must report changes in income.
- During the year, you must go back into your application to report if your income goes up or down. This will keep your monthly premium at a manageable price and help to reduce the amount of financial assistance you may have to pay back, if any at all.
You can receive financial assistance.
- Estimating your income as accurately as possible allows the Marketplace to determine your eligibility for financial assistance.

Be sure to include:

Anticipated changes in income
- Consider these questions: How might your income change in the coming year? Are you expecting business to improve or worsen? Will you be getting a raise? Work more hours? Get a seasonal job? Will another household member get a job? Will you gain or lose a dependent?
The anticipated income of all household members
- If another person in your tax household has health coverage through a different plan or program, you still need to include their income on your application. Marketplace financial assistance is based on the income of all tax household members. You will be able to clarify on the application which household members do not need health coverage. Tax household members not applying for coverage are not required to provide any other information except income information (e.g. They do not have to provide a Social Security Number).
Some disability-related income
- Only include Social Security disability payments when estimating your income for next year. Do not include Supplemental Security Income, only Social Security retirement or disability payments.
Income from investments
- Things like stocks and bonds.
Alimony
- Include only if your divorce or separation was finalized before January 1, 2019.

Do NOT include:

Self-employment expenses
- Subtract any self-employment expenses from your estimated income.
Some disability-related income
- Do not include Veterans’ disability income payments, Supplemental Security Income (SSI) payments, and workers’ compensation payments when estimating your income for next year.
Social Security payments for applications that have not yet be approved
- You can update your Marketplace application later next year if your application is approved.
Alimony
- Do not include if your divorce or separation was finalized on or after January 1, 2019.
Child support

Free appointments with a local navigator can be made using the statewide appointment hotline at 1-855-733-3711, or online at www.ncnavigator.net. Appointments are filling quickly!

More Resources:

More information on how to report your income: https://www.healthcare.gov/income-and-household-information/how-to-report/

And on what to include: https://www.healthcare.gov/income-and-household-information/income/

NAVIGATING OPEN ENROLLMENT: Top Four Mistakes To Avoid

Posted on September 27, 2021

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

GET COVERED

Woman holds child while talking on the phone and taking notes

Charlotte Center for Legal Advocacy’s health insurance navigators help families and individuals choose plans that are best for them within the Health Insurance Marketplace implemented under the Affordable Care Act (ACA). During the Open Enrollment Period, navigators take appointments free of charge with residents of Cabarrus, Mecklenburg and Union County who are concerned about making common errors that could jeopardize their ability to maximize coverage and minimize cost.

Find FAQs and how to make an appointment and keep reading to learn the top four mistakes navigators see people make on the Health Insurance Marketplace.

1. Missing the Deadline

The Open Enrollment Period is going on now through Jan. 15, 2022. It is very difficult to qualify to sign up for health insurance on the Marketplace beyond the designated timeframe. Usually, adjustments or new enrollments are allowed only as a result of a major life event, such as marriage, divorce, job loss or a new child.

2. Misunderstanding Costs

During Open Enrollment, some people only look at the cost of premiums and don’t take into consideration the deductibles, copays, coinsurance and out-of-pocket maximums. These are all important factors that will help determine your overall health care costs in 2022.

3. Over- or Under-Insuring

A basic high-deductible plan generally has the lowest monthly premium, but it requires the policy holder to spend more before full coverage kicks in. Some people mistakenly select this option because they think it will be cheapest, but they ultimately pay more out of pocket. Navigators suggest a quick assessment of your health care spending over the last couple of years. If you tend to undershoot your deductible, you might be better off moving to a high-deductible plan. If you usually hit your deductible before it resets, you could come out ahead by paying a higher premium for a heartier plan. Remember: The cost of many preventive measures, such as mammograms, colonoscopies and cholesterol screenings, are covered 100% before you meet your deductible and require no copay.

4. Opting Out

A few years ago, not buying health insurance meant facing a potentially costly penalty. While that penalty no longer exists, forgoing coverage is a big mistake. A single illness or injury could total thousands of dollars out of pocket.

Still looking for the answer to your question or need additional guidance to get signed up on the Health Insurance Marketplace? Make an appointment with a navigator and sign up for additional information today.

Eviction Assistance and Resources

Posted on September 8, 2021

The eviction moratorium has ended, but there are still legal and financial resources available.

We brought together Juan Hernandez, Staff Attorney, Charlotte Center for Legal Advocacy and Erin Barbee, Senior Vice President Programs & Fund Development, DreamKey Partners, to answer common questions and share helpful information for community members facing eviction.

Find a copy of the presentation and links to key resources here.

Unemployment Insurance: FAQs

Posted on September 1, 2021

Where can I apply for benefits?

Apply online at des.nc.gov or by phone 1-888-737-0259. The quickest way to apply is online.

Why can’t I get through to the NC Division of Employment Security (“DES”) by phone?

DES has a high volume of callers requiring assistance due to COVID-19. Document any attempts to contact DES by phone. DES is working to improve this issue.

I am a self-employed worker or independent contractor – can I apply for unemployment insurance?

Self-employed, independent contractors, gig workers and others who did not traditionally qualify for North Carolina unemployment insurance and were receiving unemployment benefits through Pandemic Unemployment Assistance (PUA) and Mixed Earners Unemployment Compensation (MEUC) will no longer be eligible for unemployment after September 4, 2021.

When should I submit weekly certifications?

Weekly certifications must be submitted on the DES website for every week you have filed for unemployment, including any weeks you are awaiting eligibility from DES. Failing to submit weekly certifications will delay benefit payment.

What does a “pending claim status” mean?

If your DES claim shows your claim is “pending” this means that DES is still assessing your eligibility for unemployment insurance. Continue to submit weekly certifications during this time.

Where can I receive additional information?

Visit the DES COVID-19 help website or review helpful resources available after the Federal Pandemic Unemployment benefit ends on September 4, 2021.

How to Make the Most of Your Healthcare.gov Plan

Posted on August 23, 2021

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

GET COVERED

You took the step to enroll for health insurance coverage using Healthcare.gov. Congratulations! You’ve joined more than 31 million people who have the peace of mind of knowing they are covered with access to preventive health care and life-saving screenings.

Take advantage of free services.

Preventive health services are included in every Healthcare.gov plan and are free. They are routine health care procedures such as screenings, check-ups, and counseling to prevent illness and other health problems.

All Healthcare.gov plans are required to cover preventive health services 100%. This means that insurance companies cannot charge you a copay or coinsurance to get this type of medical attention. For example, an annual check-up, immunizations, children’s vision screenings, contraception and well-woman visits are free. You’ll just need to show your health insurance card at your doctor’s office. Get specific lists of preventive services for adults, women and children.

Preventive services are free only when you get them from a doctor or other provider in your plan’s network. (A network is the facilities, providers and suppliers your health insurance company has contracted with to provide health care services.) Talk to your doctor about taking advantage of these free services to keep you and your family healthy.

Look at the Summary of Benefits and Coverage.

To understand your plan better, and to be prepared in case of illness or an emergency, read the Summary of Benefits and Coverage that comes with your plan. Log in to your Healthcare.gov account or call your health insurance company to get a copy.

This document will give you a snapshot of your possible costs throughout the year and includes examples of common medical events. For example, it will explain how much a hospital visit or prescription drugs will cost you.

Know where to go for care.

You can get health care at many different places, including the emergency department when you’re injured or very sick. But it’s best to get regular care from a primary care provider (often a doctor at a family medicine clinic). Primary care providers work with you to make sure that you get the right services, manage your chronic conditions and improve your health and well-being. It might take more than one visit to figure out if a provider is right for you, so it’s important to be proactive and start your search now.

If you aren’t sure how to find a doctor in your area, your health insurance company’s website is a good place to start. If you have a health insurance plan in the Charlotte area, use the following provider search tools:

Or, if you know of a doctor that a friend or family member recommended to you, you can call that doctor’s office to see if they accept your health insurance plan. Remember, your care will be a lot cheaper if you go to a doctor in your health plan’s network.

Check out this guide for more great tips on how to make your health insurance work for you.

If you have questions about your coverage, or your income or health care needs change at anytime, call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

Beware of COVID-19 Foreclosure Rescue and Forbearance Assistance Scams

Posted on July 20, 2021

By Niayai Lavien

Many homeowners are facing increased financial hardships due to unemployment and COVID-19. Scammers are taking advantage of the current economic fallout of the pandemic and employing elaborate scams to trick homeowners out of their properties. Older adults and the economically disadvantaged are more likely to be targets of these abusive practices.

The CDC’s federal eviction and foreclosure moratorium ends on July 31, 2021. The moratorium allows individuals and families living in federally financed properties to stay in their homes throughout the entirety of the COVID-19 pandemic. It also allows families to receive financial assistance to stay current on their rent and mortgage payments.

With the moratorium ending, consumers, especially homeowners, should know their options and learn how to prevent themselves from being scammed.

A foreclosure rescue scam is when a scammer tricks a homeowner into signing away ownership of their home for dramatically less than its current worth. Scammers often target homeowners who are in the middle of foreclosure by promising that they can stop a foreclosure from happening while hiding the fact that the homeowner is signing over title to the property.

Scammers search public records to prey on homeowners who are in danger of foreclosure through failure to pay property taxes, mortgage or homeowners association dues. They also look for older homeowners who have paid off their mortgage, but have trouble with the financial upkeep of their home.

Common abusive practices include:

Aggressive solicitation via phone, text message, mail and door hangers
Downplaying the value of the home
Pressure to sign a document or contract without the presence of a Realtor or attorney

Whatever the particular factors surrounding a homeowner’s situation, the scammer’s goal is to steal the home’s dollar while a person is in a high pressure situation.

Do’s and Don’ts of Foreclosure Scams:

Don’t → Fall for unsolicited offers to buy your home or help you sell your home without any cost.

Don’t → Make a decision regarding your home without getting a second opinion.

Don’t → Be pressured into signing any papers until you’ve talked with an attorney.

Do → Consult with a HUD approved counseling agency to talk about your options.

Do → Be wary of out-of-state law firms, organizations and groups offering to provide assistance.

Do → Contact Charlotte Center for Legal Advocacy’s Consumer Protection Team for assistance at 704-376-1600.