shop. compare. choose. · yhi goals . your health idaho . state-based success • met all...
TRANSCRIPT
In the last eight months we’ve worked diligently to meet the goals placed in front of us.
1. We are keeping Idaho in control of our marketplace and preventing
federal intervention in Idaho.
2. We are providing Idaho based resources to thousands of Idahoans who want health insurance.
YHI Goals
Your Health Idaho
State-based Success
• Met all regulatory requirements to keep Idaho in control and qualified as a state-based marketplace
• Smallest staff and low grant funding compared with other state
exchange • Set up a board of 19 volunteers, established governance, and are
fine tuning responsibilities and accountability standards • Identified a plan for setting up our own marketplace for
sustainability in 2016.
Your Health Idaho
State-based Success
• Established a website to act, for this first year, as a portal to
the federal exchange
• Created Idaho-based resources for consumers to make up for the shortcomings of the federal website, including tools to estimate tax credits, find consumer assistance and compare plans
Your Health Idaho
State-based Success
• Built a network of over 500 Agents and Brokers and 300 In-Person Assisters to help Idahoans
• Completed our first financial audit in accordance with the
enacting legislation
• Preparing our first report to the Legislature
A state-based exchange
keeps control in Idaho.
Why a State Exchange?
• Plan Management • Consumer Assistance Program • Fees
• Governance and Funding • Technology • Agents and Brokers
In-Person Assisters
In-Person Assisters: In Idaho, we made security and trust our top priorities. • Employees or volunteers from trusted, established non-profit entities
around Idaho • Trained and cleared through national background checks
Our Partners: Idaho Primary Care Association
Mountain States Group Public Health Districts
Idaho Association of Counties Idaho Hospital Association
Community Action Partnership of Idaho
Agreements Pending Kootenai, Coeur d’Alene, Nez Perce, Shoshone-Bannock and Shoshone-
Paiute Tribes
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Updates
Jan 1 Enrollment: Enrollment date has moved to December 23rd for coverage beginning on Jan. 1, 2014. Open enrollment will continue through March 31, 2014.
Technology: The federal site appears to be functioning better, but Idaho is moving forward to have our own technology system in 2014.
Plan Cancellations: The Governor called for plan continuation and Idaho’s insurance carriers will determine whether or not they will offer to extend coverage of existing plans through 2014.
SHOP: SHOP enrollment will be available through agents and brokers or direct enrollment for 2014, the online process will not be available until 2015.
Security Verification YHI escalated questions through HHS/CMS Confirmed with CCIIO Director: • All “live” functions of the website have passed security testing
• Standards are the same as the Medicare system
• All functions that are not “live” have not completed security testing.
Security
YHI Consumer Resource Center 6,500 calls 500 emails 565 referrals to agents and brokers and IPAs HealthCare.Gov Call Center: 12,000+ calls from Idaho
What we are hearing
YHI Website 120,000 unique visitors 618,452 page views HealthCare.gov Improved function
What we are seeing
A look at activity in Idaho Oct 1- Nov 2, 2013
4,753 completed applications 10,573 Idahoans included in completed applications 7,733 Idahoans eligible to buy a plan on the marketplace 3,305 applicants eligible for Tax Credit 338 Idahoans selected a plan
Enrollment Numbers
State Applications Completed
Alaska 1,253 624
Wyoming 1,353 85
Hawaii 1,754 NA
Montana 2,863 212
New Mexico 4,055 172
IDAHO 4,753 338
Utah 6,186 357
Nevada 9,186 1,217
Colorado 20,492 3,736
Texas 53,904 2,991
Washington 64,990 7,091
Florida 67,366 3,571
California 105,782 35,364
Other State Enrollment
http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf
Oct 1 – Nov 2, 2013
State Start Date Grant money Applications Enrolled Federally Managed
Marketplace
Alaska 2010* N/A** 1,253 624 Federal
Wyoming 2010* $800,000** 1,353 85 Federal
Montana 2010* $1,000,000** 2,683 212 Federal
Utah 2010* $2,000,000** 6,186 357 Federal
Texas 2010* $1,000,000** 53,904 2,991 Federal
Florida 2010* N/A** 67,366 3,571 Federal
Other State Enrollment
http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf
Oct 1 – Nov 2, 2013
* Indicates the date the federal government began building the FFM, ** Does not reflect the amount of money spent to build the federal program.
State Approx. Start Date Grant money Applications Enrolled State Based Marketplace
Hawaii 6/2012 $205,342,270 1,754 NA State
New Mexico 12/2012 $53,879,483 4,055 172 State (transition)
IDAHO 4/2013 $69,395,597 4,753 338 State (transition)
Nevada 12/2012 $98,700,000 9,186 1,217 State
Colorado 10/2012 $178,683,411 20,492 3,736 State
Washington 7/2012 $181,392,299 64,990 7,091 State
California 7/2012 $910,606,370 105,782 35,364 State
PCG Public Consulting Group
• Consumer Connector Program • DHW coordination • Grant establishment
Gallatin Gallatin Public Affairs
• Strategic communications • Media • Marketing • Grassroots outreach
PMO Project Management Office
• Vendor oversight, tracking • Reporting • CMS/CCIIO compliance
Technology
Solution & Integration
• Strategy and plan • Design system • Migration from federal system • System hosting
Verification Independent Verification &
Validation
• 3rd party; audit function • Implementation oversight • Quality standards • Privacy and Security controls and testing
Consumer Resource Consumer Support Center
• Respond to calls, e-mail, postal mail • Eligibility and enrollment assistance • Consumer aids and materials • Referrals to agents and brokers
Vendors
• Federal liaison • Materials • Market research • Web design and tools
• Industry research • Procurement
• Quality assurance • Risk management • Change requests
• Systems integration • Testing, Quality • Maintenance and operations • Privacy and security controls and testing
• Appeals and grievances • Language capabilities • Customer noticing processes
Temporary
Temporary
Temporary
Temporary
Building our own solution RFP Process
• Pleased with the quantity and quality of proposals we received
• Identified finalists
• Exercising due diligence for Idaho to avoid issues the federal
marketplace had
• Move into contracting as quickly as possible
Idaho Technology
1. Idaho has successfully met all requirements to keep our exchange controlled in Idaho.
2. Idaho’s marketplace is build for Idahoans, by Idahoans.
3. We are moving forward to build an exchange that is sustainable by 2016.
Summary