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Maryland Health Benefit ExchangeImplementation Advisory Committee

MeetingSeptember 18th, 2014

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Welcome & Approval of Minutes

Michele EberleActing Director, Plan & Partner ManagementMaryland Health Benefit Exchange

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HBX System Updates/Rate and Benefit Extracts

Dennis Glorioso, MHBE PMO

4

Glossary

SIT – System Integration Testing

UAT – User Acceptance Testing

EDI – Electronic Data Interchange

Release 1 – Plan Management

Release 2 – Eligibility & Enrollment

5

Agenda

System Implementation Timeline

Release 1 UAT

Release 2 SIT & UAT

Meetings

6

System Implementation Update - Timeline

6

UAT

Today

7

Release 1

Received feedback on rate and benefit extracts

Received updated plan templates

Correcting the major defects on our side identified with internal review and your feedback

Loading the latest and greatest tomorrow morning

8

EDI Testing

Ongoing EDI 834 testing– Please reach out if you have concerns

Completion by October 3– Receive all 999s and 834 effectuations

9

Off-site testing

Thank you for taking the time to meet with us individually to review anonymous browsing

Details on plan shopping validation will be emailed tomorrow

Require updated templates by COB Friday, September 26– Focus on plan display Monday, Tuesday, & Wednesday of next week– Reach out with any issues you encounter– Plan Services has a documented plan update process for production

Off-site testing will include additional functionality– Ability to create an application– Generate an 834– Complex scenarios– Require close coordination with our team. Details will be sent separately

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On-site Testing

October 13 – October 17: structured carrier UAT testing– Full access to end-to-end system – hitting the FDSH, identity proofing, generating

834s, etc.– MHBE-defined & ad-hoc scripts

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Plan Management Items

Plan Services

2015 Individual Market Plans

Individual Market Plans Available for 2015Participating Medical Carrier/Lices

Number of

Plans Metal Levels Available All Savers (United Healthcare) 8 2 Bronze, 4 Silver, 1 Gold, 1 CatastophicCareFirst of Maryland Inc. 4 1 Bronze, 1 Siver, 1 Gold, 1 PlatinumCareFirst BlueChoice, Inc. 11 3 Bronze, 3 Silver, 3 Gold, 1 Platinum, 1 CatastrophicCigna Health and Life 3 1 Bronze, 1 Silver, 1 GoldEvergreen Health Cooperative 12 4 Bronze, 3 Silver, 3 Gold, 1 Platinum, 1 Catastrophic

Group Hospitalization and Medical Services, Inc. (GHMSI) 4 1 Bronze, 1 Silver, 1 Gold, 1 PlatinumKaiser Permanente 10 3 Bronze, 3 Silver, 2 Gold, 1 Platinum, 1 Catastrophic

OPM on behalf of CareFirst of Maryland (Multi-State Plan) 2 1 Silver, 1 GoldOPM on behalf of GHMSI (Multi-State Plan) 2 1 Silver, 1 GoldUnited Healthcare of the Mid-Atlantic, Inc. 5 2 Bronze, 2 Silver, 1 Gold

2015 Individual Market Plans

Number of Plans by Metal Level

Bronze 17

Silver 18

Gold 13

Platinum 5

Catastrophic 4

State Benchmark Plans

Eighteen different silver level plans will be offered this year on the Maryland Health Connection

Of these eighteen plans, three will serve as benchmark plans for the 2015 plan year.

Rating Areas 1 and 2 :– Evergreen Health HMO Silver HSA/HRA 1700 Plan

Rating Area 3:– BlueChoice HSA Silver $1300 Plan

Rating Area 4:– KP MD Silver 1750/25%/HAS/Dental/Ped Dental

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Premium Payment Guide - Reminder

Copy at carrier’s discretion but must include:

Methods of acceptable payments and payment dates

Modes of invoicing

Relevant Departments and Phone Numbers

Directions for logging into member portals

or A URL with this information

Instructions for when a consumer has not yet received an invoice

Written Direction For Consumers

Carrier Webinar & Presentation Due Dates

All carriers will give their Navigator presentations on 9/19

Editing and production phase 9/22 through 9/26

Carrier review will occur concurrently

Final product 10/1

Please submit presentation materials by: 9/22

Carrier Handoffs – Warm Transfer Table

The Warm Transfer table describes the scenarios whereby the MHBE Call Center would connect a consumer to a specific customer service resource at a respective carrier.

This information is built into Call Center Representative training.

The number of warm transfer resources are at a carrier’s discretion.

MHBE will distribute last year’s document to the carriers

New carriers are required to add language to the document

Please submit edits and updates by 9/26

Carrier Name Reason for Warm Transfer to Carrier

Phone Number

Business Hours

Special Instructions for Callers

Producer Appointment/Broker File Point of Contact

Carriers must provide MHBE a point of contact (or instructions) for:

1. Producer Appointments

2. Producer Demographic File (Broker File)

Please submit information by 9/26

Provider changes to record for CRISP

MHBE will rely on carrier to submit changes, i.e. source of truth.

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Life Events Update

Nabila Rahman, Optum

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QDP Renewals & SADP Shopping

Michele Eberle, MHBE Plan Management

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MHBE Communications

Michele Eberle, MHBE Plan Management

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SHOP Update

Stephanie Lee, MHBE Plan Management

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NEXT MEETING:

October 2nd, 2014

2:00 – 4:00PM

UMBC Tech Center

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