new york health benefit exchange - hcfany · name, logo and brand strategy creation ... • plan...

New York Health Benefit Exchange

Sara Rothstein Assistant Director for Policy and Planning


Health Care for All New York

March 28, 2013

www.HealthBenefitExchange.ny.gov


• Declaration Letter sent to HHS on July 9, 2012 http://healthbenefitexchange.ny.gov/news/governor-cuomo-issues-declaration-letter

• HHS Design Review Oct 9-10, 2012

• HHS Exchange Blueprint submitted Oct 26, 2012 http://www.healthbenefitexchange.ny.gov./news/state-submits-blueprint-application-hhs

• Exchange received conditional accreditation from HHS on December 14, 2012 http://www.healthbenefitexchange.ny.gov./news/new-york-receives-conditional-approval-operate-state-based-exchange

• Open Enrollment from October 1, 2013 – March 31, 2014

• Exchange coverage effective January 1, 2014

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The Timeline for Establishing the Exchange

http://healthbenefitexchange.ny.gov/news/governor-cuomo-issues-declaration-letter









http://www.healthbenefitexchange.ny.gov./news/state-submits-blueprint-application-hhs










http://www.healthbenefitexchange.ny.gov./news/new-york-receives-conditional-approval-operate-state-based-exchange


















Awarded nearly $370 million in federal funds for Exchange establishment activities

Established and convened five Regional Advisory Committees

Conducted background research on key policy decisions

Contracted with a System Integrator to build IT system

Key Accomplishments to Date



Contracted with customer services organization

Invited Health Plans to Participate in the Exchange

Invited organizations to apply to be In-Person Assistors/Navigators

Received conditional certification from HHS in December 2012

Implementation Impact of Exchange and Reforms in NY Full Implementation

• One million people will gain insurance

• Exchange enrollment is estimated to be 1.1 million people:


Individual Exchange(58%)

SHOP Exchange(42%)

450,000 615,000


Enrollee Characteristics, by Income

12%

12%

23%

13%

40%

SHOP Exchange

Under 138% FPL

138-200% FPL

200-300% FPL

300-400% FPL

Above 400% FPL

8%

41%

24%

13%

14%

Individual Exchange

Source: Urban Institute, Characteristics of Nonelderly New Yorkers Likely to Enroll in the Health Insurance Exchanges Under the Affordable

Care Act, February 2013.


Enrollee Characteristics, by Language

63%

37%

Individual Exchange

65%

35%

SHOP Exchange

English

Other

Note: Includes enrollees over 5 years of age.




Enrollee Characteristics, by Language

63%

18%

3%

2% 2%

2% 1%

9%

Individual Exchange English

Spanish

Chinese

Hindi and related

French

Korean

Russian

Other

Note: Includes enrollees over 5 years of age.




Outreach and Marketing Plan – Goals

• Create Awareness: when is it coming? where to go for info?

• Build Support: why is it important to you?

• Clarify Misconceptions: what the Exchange is and is not?

• Identify Engagement Opportunities: what can consumers, and other stakeholders do to prepare, engage and participate?

• Set Expectations: what will the Exchange accomplish through full implementation?

• Support Enrollment Goal: 1.1 million people enrolled through the Exchange


Preparation Mobilization Engagement Ongoing Engagement & Evaluation

Phase 1

Phase 2

Phase 3


Outreach and Marketing Plan

Phase 4


Outreach and Marketing Plan - Phase 1: Preparation

Goal: Set the stage for future outreach efforts and earn buy-in from our stakeholders

Continued Regional Advisory Committee Input

Information Website

Develop target audience outreach strategy

Engage Outreach Partners

Research & Media Planning

Surveys and Focus Group Testing

Name, Logo and Brand Strategy Creation

Message Development


Outreach and Marketing Plan – Phase 2: Mobilization

Goal: Set accurate expectations for the Exchange and build awareness for the Exchange through grassroots marketing efforts

Marketing Materials Rolled Out

General information

Individual and SHOP

Audience Specific

Launch Outreach Campaigns

Grassroots Activities

Awareness Events

Earned Media

Develop evaluation metrics


Outreach and Marketing Plan – Phase 3: Engagement

Goal: Create a call-to-action and share information to empower consumers to make informed health insurance purchasing decisions

Launch Advertising Campaign

TV

Radio

Online

Print

Out of Home (Billboards, bus and subway signs, and other public spaces)

Intensify Community Outreach through Stakeholders/Partners

IPA/Navigator Marketing and Enrollment Support in Communities

PR Campaign, Grassroots Activities and Awareness Events


Outreach and Marketing Plan

Phase 4: Continued Engagement and Evaluation

Goal: Maintain messaging momentum while retaining flexibility to respond to post-launch needs

Advertising Campaign continued

IPA/Navigator Services continued

Stakeholder/Partner Outreach continued

PR Campaign, Grassroots Activities and Awareness Events continued

Evaluation

Measure Success

Midcourse Adjustments

Consumer Assistance and Enrollment Support

1) Online — Through the Exchange portal; new applications & administrative

renewal

— Back-end eligibility operation to manage manual processing (e.g., verification documents)

— Chat process for assistance

2) In-Person — Navigators and In-Person Assistors, Brokers, Local District Social

Services, Informal assistors

3) Phone — Call center currently processes public program renewals in 18

counties, half of the renewals are completed by phone

— Requires more resources, but generates higher renewal rate

4) Mail — Centralized processing unit

14 www.healthbenefitexchange.ny.gov


Language Accessibility

• Exchange web portal will initially be available in English, followed by Spanish and later other languages

• Call center services will be available in every language

• IPA/Navigator services will be available in several languages

– RFA requires applicants to provide services that are culturally and linguistically appropriate to the populations served

• Plan invitation requires QHP issuers to make written materials and other information available in languages other than English when at least 5% of applicants/enrollees in the county of a service area do not speak English as a first language

– Alternatively, materials can provide taglines in other languages to indicate availability of materials in other languages

– Must make verbal interpretation services available

15 www.healthbenefitexchange.ny.gov


IPA/Navigator RFA

16

Goals of the IPA/Navigator Selection Process

• Ensure that all types of organizations permitted in federal rules are eligible to compete

• Provide grants to a diverse group of organizations that will provide high-quality enrollment assistance, in a manner that is linguistically and culturally appropriate to the populations being served

• “One-Stop” consumer assistance for Exchange, Medicaid and Child Health Plus coverage

• Ensure availability of assisters in all counties of the State

• Have IPAs/Navigators ready to provide assistance at open enrollment, October 1, 2013

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Program Requirements

IPA/Navigator entities will be required to: • Serve individuals, small business employers and small business

employees

– Entities may not opt to only serve individuals or only serve small businesses and their employees

• Provide services in-person to residents of New York State

– Call centers or web assistance are not funded under these programs

• Provide education to potential enrollees about the Exchange, Insurance Affordability Programs and Health Plans available to them

• Assist with health insurance applications and provide assistance at renewal

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Program Requirements

IPA/Navigator entities must (continued):

• Submit applications online

• Participate in DOH Training for IPAs/Navigators

• Comply with certification requirements

• Comply with DOH monitoring requirements

• Monitor the productivity of IPAs/Navigators

• Follow the DOH Appeal/Complaint Process

• Maintain confidentiality, privacy and security requirements

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Timeline

Activity Date

RFA Release Date February 13, 2013

Letters of Interest Due February 27, 2013

Applications Due April 8, 2013

Applicants Selected and Contracts Signed Summer 2013

IPA/Navigator Training August/September 2013

Open Enrollment Begins October 1, 2013

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http://www.health.ny.gov/funding/rfa/1301300317/index.htm

http://www.health.ny.gov/funding/rfa/1301300317/index.htm



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