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2013 was a watershed year for health care, with the implementation of federal and state-run health insurance exchanges, as well as the advent of federal subsidies designed to help consumers afford coverage. However, 2014 promises to be a year of change in healthcare as well, with a quartet of important new changes to be aware of that take effect this year. The Small Business Tax Credit applies to employers with less than 25 full-time equivalent workers who earn an average of $50,000 per year or less.  These employers could qualify for a tax credit worth up to 50 percent of their employer contribution toward their employees’ premium costs.  This credit is only available to employers who pay at least half of full-time employees premium costs, and obtain coverage through the Small Business Health Options Program, or SHOP. Medicaid is the state-federal health insurance program that protects the poor and the disabled. In 2014, 25 states and the District of Columbia are implementing a significant expansion of Medicaid, which will allow an estimated nine million more Americans to gain health insurance through the program.  Under new guidelines, non-elderly adults who earn up to 138 percent of the federal poverty level will qualify for Medicaid coverage. In 2014, new rules guarantee consumers have access to individual and small-group coverage regardless of past or current health conditions.  Health plans are also required to cover at least 60 percent of medical costs, limit the amount that older policy-holders can be charged, and do away with annual and lifetime benefit-spending limits. All individual and small-group plans must cover “essential health benefits” according to the Affordable Care Act, which include substance abuse services, pediatric dental and vision care, mental health treatment, preventative and wellness care and maternity and newborn care. The individual mandate requires individuals and their dependents to carry health insurance in 2014 or pay a penalty for noncompliance in 2015. People who enroll for coverage by March 31, 2014, will avoid penalties. The 2014 penalty is 1 percent of annual income, or $95 per person, whichever is greater. The penalties will increase each year until they reach 2.5 percent of income, or $695 per person. As these changes take effect, communication is key to promoting understanding and compliance with new rules and regulations. Clear, accurate translation of website materials, documentation and outreach materials plays an increasingly important role in accurately communicating new information.  Communicating to Limited English Proficient (LEP) consumers in their primary languages increases understanding, awareness and compliance, which enables the government to more effectively do its job, and consumers to benefit more readily and directly.

Although Covered California continues to boast strong enrollment numbers, Latino sign-ups are not keeping pace with general population numbers. Out of 400,000 Covered California customers who responded when asked about their ethnic background, less than 20 percent identified themselves as Latino, Hispanic or Spanish. These numbers are concerning, especially since Latinos make up more than half of California’s 7 million uninsured residents. The success of Covered California rests in part on strong numbers of young, healthy enrollees, and California’s Latino population tends to fit this profile. This discrepancy between Latino healthcare enrollees and the actual number of eligible, uninsured Latinos in California underscores the importance of providing LEP customers with information in their primary language. Latinos face both linguistic and cultural barriers when attempting to read, understand and navigate the Covered California website. Aside from translation errors that caused difficulty in understanding the website and online enrollment portal, cultural barriers are also a problem. Potential Hispanic applicants are wary of divulging personal and financial information they feel could be used against their families in a deportation situation.  Some families have mixed-immigration status: undocumented parents with documented children – and these families fear that by providing the personal information required to enroll, they risk deportation. Although Immigration and Customs Enforcement has assured applicants that this information cannot be used for enforcement purposes, Latino groups remain skeptical. To encourage Latinos to sign up for healthcare, Covered California is seeking to address many of these problems. Fixing translation issues on the website, hiring more bilingual counselors, and providing greater outreach to Latino populations all play a part in encouraging more Spanish-speaking customers to sign up. As both Covered California and CuidadoDeSalud.gov grapple with issues related to translation, it is clear that choosing a translation company that provides exceptional, high-quality translation is critical to a successful outcome.

As customers accessing the federal government’s healthcare portal, healthcare.gov, finally see positive improvements in the online enrollment process, the Spanish version of the website, CuidadoDeSalud.gov, is undergoing its own unique set of problems. According to the Associated Press, typos, confusing sentence structure, grammatical errors and non-working links are causing confusion and frustration for Spanish speaking healthcare consumers attempting to navigate CuidadoDeSalud.gov. The awkward, difficult-to-understand sentences are so full of grammatical mistakes that critics have concluded they must have been done through computer-generated translation, rather than through the use of “live” translators who are fluent in the nuances of the Spanish language. Adding to the frustration, when users clicked on links that compared insurance plans, they were taken to the English version of the comparisons. Far from being the consumer-friendly site government officials hoped for, the problem-plagued CuidadoDeSalud.gov has most likely hindered Spanish-speaking consumers from signing up for healthcare.  New Mexico has the nation’s highest percentage of Latino residents, yet in October and November, fewer than 1,000 Latinos signed up for coverage. Other states with high Spanish-speaking populations experienced disappointing numbers as well. Approximately 15 million Hispanics are uninsured, and their participation is crucial to the success of Obamacare. However, unless the problems with CuidadoDeSalud.gov are addressed, Spanish-speaking individuals will continue to lag behind in their attempts to enroll in health insurance. The problems with CuidadoDeSalud.gov underscore the critical importance of providing translation that is accurate, grammar-free, culturally appropriate and fully understandable by the target audience. This is accomplished by employing skilled translators, not by using machine or computer-generated translation. Using computer-generated translation typically results in documents that are difficult to read and understand. Using “real” translators – people who are translators by trade, fluent in both English and the target language and experts in linguistic nuances – are always a better choice, especially when the stakes are as high as they are with CuidadoDeSalud.gov. Choosing an organization such as Avantpage ensures that your translated documents are flawlessly presented in your target language. Reading level, comprehension, cultural differences and shades of meaning are all taken into account. As a result, your translated materials read as if they were produced in the target language, enabling your audience to comprehend and understand information more easily. Read also: Medicare Marketing translations  anish translations  bsite Localization  * This blog entry is based on information gleaned from an article written by Russell Contreras and Kelli Kennedy of The Associated Press. It appeared in the Sacramento Bee on Monday, January 13, 2014 under the headline, Health Site in Spanish Falls Short.

According to data just released by Covered California, more than 625,000 Californians have enrolled in Covered California health plans so far, and Medi-Cal enrollment has topped 1.2 million individuals. Demand for affordable, accessible health care is strong in California, and numbers are expected to continue to rise. Of those enrolled so far, 424,936 are eligible for federal subsidies. While the numbers are impressive, there is still much work to be done. Covered California continues to make improvements to their website and plans to increase staff numbers to handle calls, questions and eligibility concerns. December data has shown improved trends in the number of Latinos enrolling, a group which is critical to the overall long-term success of the program. Latinos account for more than half of California’s 7 million uninsured residents, and Covered California must ensure that outreach programs, bilingual enrollment counselors and fully translated materials are readily available to this demographic. Out of a grand total of 389,739 individuals who enrolled in October, November and December with subsidy status, 24,391 indicated Spanish as their preferred language; 34,234 indicated Asian and Pacific Islander languages; 955 indicated Indo-European languages and 330,159 indicated English. On the small business side of things, Covered California’s Small Business Health Options Program reports that more than 289 small businesses have applied for coverage, and a total of 2,155 employees and their dependents were provided coverage through their employers. Overall, what do these numbers and statistics mean to the translation industry?  Essentially, we can conclude that there is strong interest in healthcare coverage across cultural and ethnic demographics in California, and communicating to these groups in their preferred languages is crucial to helping them sign up for the healthcare they need.  Health plans must ensure that translated materials are accurate, culturally appropriate and ready to be distributed when needed to the ethnic groups requiring them. Avantpage offers a complete suite of translation and linguistic services in over 150 languages. You’ll find a wealth of great translation information on our website. For example: Medical & Healthcare translations Spanish translations Case Study: Spanish Translation for Healthcare 

While computer crashes, glitches, and other technological difficulties have plagued the federal government’s HealthCare.gov site, California’s exchange site is experiencing much less-severe growing pains. HealthCare.gov is a federally run health care marketplace serving 36 states. Because of the technical issues, the federal government has set up an IT task force. However, it will be some time before the site is fully operable. IT experts continue to work on the site and officials with the U.S. Department of Health and Human Services have set a November 30 deadline for having a fully functioning site. In contrast, the California’s state-run exchange, Covered California (CoveredCA.com), is running a much more smoothly as it ramps up to serve the state’s uninsured. California was one of the first states to begin planning and implementing a health insurance exchange website. According to Peter Lee, Covered California’s Executive Director, 2.2 million people have visited the Covered California site and about 126,000 have created accounts through October 19^th. (Tracy Seipel, San Jose Mercury News, 10/28/2013) Consumers have been able to access CoveredCA.com to compare plans, examine health care options and rates and begin the application process. Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs, or whether they are eligible for low-cost or no-cost Medi-Cal. Covered California serves the state’s uninsured and offers access to 11 health plans serving the state of California.

Covered California (CoveredCA.com), the state’s new Health Exchange, has enjoyed strong consumer interest during its first weeks of open enrollment. According to Covered California, more than 1.5 million unique visits were made to its website during the initial open enrollment period. More than 100,000 calls were made to Covered California’s Service Center during the same period. And more than 94,500 applications were started during this time frame. According to Covered California, 17,768 insurance agents have registered for certification to sell Covered California health insurance plans. These agents must have a valid license through the California Department of Insurance and must complete Covered California’s Certified Insurance Agent training and certification program.  CoveredCA.com, CoveredCA.com, CoveredCA.com, CoveredCA.com Covered California provides access to information and assistance for consumers who wish to sign up for affordable health care under the federal Patient Protection and Affordable Care Act. Covered California offers consumers help with comparing and selecting appropriate health insurance plans. California’s health exchange helps individuals discover what type of assistance they are eligible for and which federal tax credits and subsidies apply. Small businesses also are able to purchase competitively priced health insurance plans to offer their employees a range of health care options. More statistical information will be released later in the month. We will keep you posted as to any new developments and information we receive from Covered California (CoveredCA.com).

Continuing to meet our clients’ increasing and diverse language needs, Avantpage now offers braille translation services. The braille system was developed in 1824 by a French teenager named Louis Braille. Louis had become blind at the age of three due to a household accident. While attending a school for the blind in France as a teenager, Braille learned of a system used by the French Army called “night writing” in which soldiers could communicate written messages at night by touch. The system used by the army was complex and used dots and dashes pressed into paper as code for sounds. Louis Braille sought a way to simplify night writing and create an accessible tactile alphabet that could be read easily by touch. He created his system out of raised dots, pressed onto a piece of paper through the use of a pointed object. The dashes used in the army’s system were too difficult to feel consistently, so Braille decided to use dots exclusively. The number of dots and the systematic way in which they are arranged corresponded with characters in the French alphabet. The system created by Louis Braille as a teenager was not widely accepted until after his death at age 43. However, its ease of use caused braille to eventually be adopted by many different countries as a way for the blind to read and write. Today, after two centuries, Louis Braille’s system is still in use, continuing to transform the lives of blind and visually impaired people the world over. “Access to communication in the widest sense is access to knowledge, and that is vitally important for us if we [the blind] are not to go on being despised or patronized by condescending sighted people. We do not need pity, nor do we need to be reminded we are vulnerable. We must be treated as equals – and communication is the way this can be brought about.” – Louis Braille, 1841 Braille can be translated into many different languages using specialized braille translation software. At Avantpage, offering braille translation as one of our services fits exceptionally well into our overall mission and vision of enhancing communication and understanding through different languages and cultures. Although braille is a writing system all its own, it can also be translated into languages other than English. This enables visually impaired people from many different ethnic backgrounds to read braille materials in their native languages.

Close to One Million New LEP Healthcare Clients California’s new Health Exchange, Covered California, rolled out on October 1, in accordance with the Affordable Care Act. Covered California is now offering a six-month open enrollment period. Tens of thousands of Californians logged on to access the exchange’s website and learn about the available health insurance options. Covered California is implementing statewide efforts to contact and educate uninsured consumers and encourage them to enroll. Delivering this information to a diverse group of potential health care consumers is difficult for many reasons. Chief among the reasons is the fact that a large number are considered Limited English Proficient (LEP). According to a joint study by the California Pan-Ethnic Health Network and the UCLA Center for Health Policy Research and the University of California, Berkeley Labor Center, approximately one million people who are eligible for federal subsidies within the new health care program are LEP. California has the largest minority population of any state, with about 22.3 million people classified as minorities. They make up multiple ethnic populations within California. So reaching out to eligible healthcare consumers must be accomplished through the use of multiple languages. Accurate, high-quality translation of websites, documentation, outreach materials and health plan information is vital to the success of Covered California. Translation companies like Avantpage are poised to play a key role in the process. In California, Spanish, Chinese, Arabic, Armenian, Farsi (Persian), Hmong, Khmer (Cambodian), Korean, Russian, Tagalog and Vietnamese are just some of the languages spoken by the state’s minority population. Many of these people are not comfortable communicating in English. As Covered California continues to reach out to LEP populations and enroll new consumers in its healthcare program, translation takes on a critical role in catering to the health needs of California’s minority population.

At Avantpage, we are always searching for ways to service our customers more effectively and deliver language solutions that will enhance their communication initiatives. Recently, we’ve added three new services to our line-up, and we’re excited to let all our customers know about them. So much of our clients’ critical information is delivered through written materials: documentation, consent forms, instruction forms, benefits information, hand-outs, brochures, website updates, etc. Individuals with visual impairment, learning disabilities or reading difficulties had trouble accessing this information – until now. As part of our suite of language services, Avantpage now offers
Alternative Formats into Braille, Audio and Large Print. Braille – This tactile language is read by individuals who are blind or who have extremely limited vision. Avantpage can translate all your documents into Braille, including complex forms, graphs and tables. We can handle any type of document, from single-page letters to reports, catalogues, books and more. The process is simple: Just send us your document, and we take care of everything else. When you translate into Braille, you increase your organization’s accessibility, provide great customer service and give your visually impaired clients full access to the information they need. Audio – Using audio is an effective way to offer customers with visual impairments or reading difficulties access to information through clear, easy-to-understand recordings. We oversee the entire process, from selecting and hiring voice talent to sound editing, mixing and recording. When you offer audio as one of your communication options, you provide your visually impaired clients with a positive way to understand and absorb large amounts of information without having to rely on the written word. Large Print – Large Print documents are utilized by people who cannot comfortably read regular font sizes. Large Print translation is much more than “making the letters bigger.” Large Print transcription involves choosing font sizes, colors and presentation styles for optimum visual impact. Creating Large Print documents is a complex formatting process, and Avantpage takes care of it all – delivering accurate, readable, Large Print documents swiftly and cost-effectively. We hope you’ll take advantage of our new Alternative Format services to be able to effectively reach and communicate with all your customers. For more information, contact Avantpage today!

This fascinating and complex language currently has between 120,000 and 170,000 speakers. Most of these speakers live on the Navajo Nation reservation and in other areas of New Mexico and Arizona. Navajo is an important heritage language, with a rich history. However, children are taught English during school, and English is spoken more often at home than Navajo. For this reason, the number of Navajo speakers is decreasing, and the language has an endangered status. Navajo officials are working to promote and preserve this language. Originally, the language was oral only, but during the 1800s, missionaries began creating an alphabet based on the English alphabet. This written language has evolved slowly as linguists and interpreters worked with Navajo speakers to create a written language. In 1910, Franciscan missionaries published Vocabulary of the Navajo Language. Today, the language is both written and spoken. During World War II, the Navajo language entered the national and international spotlight. Navajo code talkers were employed by the United States government to encode, transmit and decode messages. This language was ideal for use as a code that the enemy just couldn’t crack. It was ideal for a number of reasons: Navajo code talkers were widely recognized for their contributions to WWII. Major Howard Connor, 5th Marine Division Signal Officer stated, “Were it not for the Navajos, the Marines would never have taken Iwo Jima.” (Naval Historical Center, Navajo Code Talkers: World War II Fact Sheet) Recently, there have been high-profile attempts to keep the language alive. For example, in 2013, Star Wars was translated into Navajo. This marked the first time any major motion picture was translated into a Native American language. Avantpage has been asked to translate into Navajo, and we are pleased to add this language to our roster. We hope to help Navajo speakers continue to speak and use their language, keeping it off the endangered list.

On October 1, 2013, Californians will begin enrolling in California’s new health exchange, Covered California. Starting three months later, in January 2014, most people must prove that they carry health insurance or face fines and penalties. Californians who carry health insurance through their employers will not be affected by these changes. But for the roughly seven million uninsured Californians, the Affordable Health Care Act and Covered California offers much-needed coverage at affordable rates. For the first time, health care consumers have the ability to comparison shop through an online marketplace to find the health care package that fits their needs and budget. What does this mean for health plans? As Covered California takes effect, qualified health plans must be ready to operate and compete in an open marketplace environment. Outreach initiatives, competitive pricing, clear and accurate communication about the plans and packages you offer all come into play during the transition period. As thousands of uninsured consumers prepare to purchase insurance – many for the first time – it is critical that information is presented in clear language that is culturally and reading-level-appropriate for new audiences. If you have supplemental marketing or informational documents, translating these into the core languages of your plan’s target audiences allows new health care consumers to accurately assess your plan’s offerings. To find out more about Avantpage's translators and our membership in the American Translators Association, call 877-ANY-LANG or email info@avantpage.com today! Contact Avantpage for all your high-quality, accurate translation needs. We have translators, technical specialists and support staff in place and are fully prepared to handle additional translation needs from both our current and new clients. We will work with you to ensure that your health care materials, essential benefit descriptions, forms, website materials and other information is accurately translated into as many languages as you need to reach new health care consumers.

To find out more about Avantpage's translators and our membership in the American Translators Association, call 877-ANY-LANG or email info@avantpage.com today!