A service of Maryland Health Benefit Exchange

Maryland Health

Connection Update

Annual Blockbuster Event September 25, 2014 Carolyn A. Quattrocki Executive Director

Update on 2014 Enrollment

Upgrade of Website

Plans for 2nd Open Enrollment (OEP) – Certification of 2015 Plans and State’s Benchmark Plan

– Re-enrollment for current MHBE consumers

– Consumer Assistance

• Call Center

• Connector Entities

• Insurance Producers

• Certified Application Counselors

– Marketing and Outreach

SHOP

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Scope of Presentation

Total enrollment: Almost 458,000 Marylanders QHP enrollment as of 9/20/14: 81,091* Medicaid enrollment as of 9/29/14: 376,850 – Includes 95,889 PAC enrollees enrolled into full Medicaid 1/1/14 – Net change in Medicaid enrollment since 12/31/13 is +262,979

Ongoing 2014 enrollment – Special Enrollment Periods for consumers with life changes (e.g. baby, marriage,

loss of job, etc.) – Medicaid eligibility determinations and enrollment year-round

*QHP enrollment is unduplicated enrollment minus cancellations of existing policies. Consumers with special enrollment periods (SEPs) because of changes in circumstances can lead to redetermination of eligibility and cancellation of QHP coverage.

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Update on 2014 Enrollment

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MHC QHP Enrollment by County

As of 5/31/14

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Medicaid Enrollment Growth by County

December 2013 – April 2014

Individuals whose coverage was converted from the Primary Adult Care Program into full Medicaid on January 1, 2014, are counted as April 2014 enrollments, but not December 2013 enrollments. Source: Medicaid Management Information System (MMIS), Department of Health and Mental Hygiene, December 2013 and April 2014.

Upgrade of Website

Proven Success: CT’s marketplace and website one of most successful in the country; same contractor transferring new system for Maryland.

No Wrong Door: enables MD to continue integrated approach in which consumers use MHC to determine eligibility for either qualified health plans with financial assistance or Medicaid.

Retain Autonomy of State-based Marketplace: Allows Maryland to continue its own robust consumer assistance programs and community-based outreach, certification and development of standards for qualified health plans, etc.

Disciplined and Phased Software Development: Adaptation of CT’s software only where necessary, with further enhancements post-November 15; close coordination with MHBE operations, carriers, and other stakeholders.

Focus on Improving Consumer Experience: Relative simplicity of application, ability to upload verification documents, anonymous browsing, and other features will enhance consumer usability.

Rigorous Testing: Extensive system and user acceptance testing underway to ensure best possible performance of system.

Adoption of Connecticut Software

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Upgrade of Website: Consumer Portal

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Click Start New Application

Consumer messages

Consumer can change password and update

household information

Upgrade of Website: Consumer Portal

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Verifications Needed by Consumers

Upgrade of Website: Consumer Portal

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Navigation Panel: Green checks

indicate completed sections

Upgrade of Website: Consumer Portal

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Each Program is listed and indicates whether the family member eligible or

ineligible

Upgrade of Website: New Broker Portal

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Clie

nt

Act

ion

s

Clicks “Get Help”

Broker Search

Click “Broker Selected”

Confirm Info & Click “Confirm”

Click “Authorize Broker to See My

Information”

Confirm “Authorize Broker”

“Accept” Client

Open “My Clients” List

Click on highlighted Client Name in List

Opens to Client Account Homepage

Bro

ker A

ction

s

Nov. 9 – Anonymous browsing and launch of new front-end consumer information website in English and Spanish; Nov. 15 -- First HealthConnectNow! Enrollment Fair; Nov. 16 -- The call center opens to take phone applications at 855-642-8572 (TTY 855-642-8573); Nov. 17 -- All authorized insurance producers and navigators are able to complete enrollments through the website and also provide in-person consumer assistance; Nov. 18 – All caseworkers at local health departments and departments of social services begin enrolling consumers through the website. Medicaid applications (currently completed through SAIL) will be directed through MarylandHealthConnection.gov; Nov. 19 -- Self-service enrollment through website becomes available for the first time to the general public and all other stakeholders.

2015 Plan Shopping Kick-off

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2nd Open Enrollment

MIA approval of forms and rates: – 57 qualified health plans approved 8/22/14; – All metal levels (Cat; bronze; silver; gold; platinum); – One new entrant in individual market (Cigna); – Among lowest rates in the country.

MHBE QHP certification: completed by end of month

Policy changes for 2015: – Pediatric dental must be embedded in all qualified health plans; – Drugs covered in medical plan must be identified in plan’s filings; – Drug formulary Internet link must connect directly to list of covered drugs

without requiring further navigation, and must include tiering and cost-sharing; – Tobacco rating prohibited.

2015 QHP information for consumer assistance workers: under development with expected completion by end of month

Certification of 2015 Plans

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Carrier Participation in 2015

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2nd Open Enrollment

Definition and function of benchmark plan: – State’s 2nd lowest silver plan within specific rating area;

– Benchmark plan’s rates used to determine amount of consumer’s advanced premium tax credit;

Maryland’s 2015 benchmark plans: – MHC will offer 20 different silver plans from 5 carriers;

– Three will serve as benchmark plans for 2015:

• Evergreen Health HMO Silver HAS/HRA 1700 plan for Rating Areas 1 and 2 (BA City, BC, Harford, Howard, AA; St. Mary’s, Charles, Calvert, Cecil, Kent, QA’s, Talbot, Caroline, Dorchester, Wicomico, Somerset, Worcester)

• CareFirst BlueChoice HAS Silver $1,300 plan for Rating Area 3 (Montgomery and Prince George’s)

• Kaiser Permanente MD Silver 1750/25%/HAS/Dental/Ped Dental Plan for Rating Area 4 (Garrett, Allegany, Washington, Frederick)

MHC 2015 Benchmark Plan

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2nd Open Enrollment

Outreach and Tracking Program:

o Beginning mid-September, outreach to make sure everyone has a plan and assistance with re-enrollment this fall.

o Brokers and navigators will then work with consumers after open enrollment has begun.

Key Message:

o If you do not re-enroll, no financial assistance available in 2015.

MHC Producer Renewals Referral Program

o MHC seeking authorized producers to participate in referral program for consumers whose plans will renew January 1, 2015;

o Participating producers will be eligible for pre-qualified referrals of MHC enrollees who request assistance from a producer.

Re-enrollment for Current MHC QHP Consumers:

It’s How to Get the Best Deal

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Facility expansion and new phone system installation – Better customer service expected; – Two locations (Baltimore and Woodlawn) with new CISCO platform for

improved call management; – Extended hours during open enrollment.

Consumer Assistance Representatives’ (CSR) preparedness – Staffing level (300 -350 CSRs) and improved process flows; – Training – new materials and scripts.

New 3-Tier Help Desk planned – Streamlined organizational structure with improved triaging; – Enhanced Level 2 support for navigators, assisters, caseworkers.; – Password resets facilitated more easily at Level 1.

MHBE constituent services

Consumer Support Center (call center)

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2nd Open Enrollment

Year 2 – Same structure with 6 umbrella organizations and community-based

partners in 6 regions of State;

– FY ‘15 contracts executed.;

– 132 navigators; 100 in-person assisters.

Navigators and Assisters’ preparedness – Mapping navigators and assisters to new HBX roles;

– Credentialing, and system provisioning for certified staff on track;

– Statewide training to begin 10/6/14.

Enrollment fairs – Increased number to be held during 2nd OEP;

– Scheduling, planning, and “playbook” underway.

Connector Entities

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2nd Open Enrollment

New Resources

– New system has well-functioning broker portal, with consumers able to request broker assistance and authorize broker to assist with application on their behalf;

– MHBE call center recently launched producer hotline, i.e. dedicated line for producers to obtain assistance;

– Additional training support planned for OE2 and new system.

Expanded Producer Referral Program

– Pivotal role in re-enrollment outreach and assistance;

– Producer engagement kick-off meeting held 9/23/14.

Insurance Producers: Enhanced Broker Engagement

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2nd Open Enrollment

Application Counselor Program Application Counselor Sponsoring Entities (ACSE) – Four new ACSEs for total of 35;

Certified Application Counselors (CACs) – 11 new CACs for total of 172.

2nd Open Enrollment

2nd OEP marketing and communications plan – based on surveys and focus groups;

– Will communicate value of insurance;

– Kick-off week to begin November 9 with anonymous browsing;

– New, front-end consumer information website in English and Spanish.

Social media campaign – Kick-off 9/16 to promote re-enrollment, enrollment, and value of coverage;

– Videos and tutorials of testimonials of current and new enrollees underway.

Non-digital materials – Revision of collaterals and education materials to reflect new system and 2nd

OEP on target.

MHBE internal partner communications – First of regular installments developed and distributed.

Marketing and Outreach

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SHOP Direct Enrollment – 185 applications as of 9/2/14;

– 1,065 covered lives as of 8/30/14;

– Will continue until launch of TPA administration of broker-assisted employee choice.

3-Phase Third-Party Administrator approach – Phase One: TPAs adapt existing infrastructure to offer SHOP plans and provide broker-

assisted employee choice (expected by 1/1/15);

– Phase Two: TPAs develop employer/employee portals (expected by 4/1/15);

– Phase Three: TPA-administered, fully automated SHOP;

– Milestone payments to TPAs;

– Significant reduction in cost of developing and operating SHOP.

SHOP Implementation – Three TPAs approved by MHBE Board at 8/19/14 meeting: Kelly Services, Group Benefit

Services, and Benefit Mall;

– Planning among TPAs, carriers, and MHBE on track;

– SHOP plans to be certified after MIA approval of forms and rates. 21

SHOP

More Information

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Sign Up for Email Updates Sign Up for Text Updates: Text “Connected” to 69302 Get information on insurance resources available Link to details on meetings and reports

MarylandHealthConnection.gov

MarylandHBE.com

Meeting Information

RFP Announcements

Job Information

QUESTIONS?

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