NV Health Link Presentation - AHIP's Exchange Conference, June 2013
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Transcript of NV Health Link Presentation - AHIP's Exchange Conference, June 2013
Nevada Health Link
June 12, 2013
Implementation Challenges
AHIP’s Exchange Conference
Operated by the Silver State Health Insurance Exchange
Agenda
1. Goals of the Exchange
2. Status of Implementation
3. Finance and Sustainability Plan
4. Outreach and Education
Can we do what we
say we will do?
Goals of the Exchange
• Increase the number of insured persons in Nevada
• Measures: Enrollment; uninsured rates
• Facilitate the purchase and sale of health insurance
• Measures: Satisfaction surveys; appeals rates; unsubsidized
enrollment; percent of customers that stay with their plans in
subsequent years; budget; PMPM costs
3
Strategic Plan
Goals of the Exchange
• Assist qualified employers in the enrollment and purchase of
health coverage and the application for subsidies for enrollees
• Measures: Employer enrollment; satisfaction surveys
• Provide consumer education on matters relating to enrollment in
and effective use of health insurance
• Measures: Awareness; seminar attendance; satisfaction
surveys
4
Strategic Plan
Goals of the Exchange
• Assist residents of Nevada with access to programs, premium
assistance tax credits and cost-sharing reductions
• Measures: Testing; secret shoppers; unscheduled web portal
down time; enrollment within one session; enrollment within 7
days
5
Strategic Plan
Can we meet these measures?
• Nevada has received Conditional Certification from the Secretary of U.S.
HHS to operate a State-Based Exchange
• The Exchange Board has approved 35 substantial recommendations of
the Advisory Committees
6
Status of the Development and
Implementation of Nevada Health Link
Are policies appropriate to
ensure geographic coverage?
Do Nevada policies add cost?
New regulations?
• IT Implementation is on-time: Eligibility Engine (DWSS/Deloitte) and
Business Operations Solution (Exchange/Xerox) will meet the October 1,
2013 deadline for operability
7
Status of the Development and
Implementation of Nevada Health Link
Will the Federal Hub be ready?
Will testing go smoothly?
Will certification go smoothly?
• Eleven group carrier onboarding meetings complete (January-May)
• Ongoing one on one meetings in tech, ops and fulfillment tracks
8
Status of the Development and
Implementation of Nevada Health Link
Will QHP rates and plan designs
be correct in system?
Will enrollment be effectively
communicated?
Will billing be correct?
• ACA Federal Establishment Grants
• Fees Charged to Carriers for
Exchange Enrollment
• Advertising
9
Finance and Sustainability Plan
Will fees disadvantage QHPs?
Are reserves and fees sufficient?
Staffing Plan Staff for policy and
contract support only
10
Executive Director
Executive Assistant
Chief Operating Officer
Grants and Project Analyst
Finance & Research Officer Information Technology
Officer Communications Officer
Administrative Assistant
Information Technology
Analyst
Training Officer
Quality Assurance Officer
Benefits Manager
Administrative Assistant
New Positions (4)
Effective 7/1/13 and 10/1/13
Current Positions (9) Board
Are staffing levels appropriate?
Outreach and Education • Plan for Navigators, Enrollment Assisters and Producers
- 44% of enrollees will use Exchange Enrollment Facilitators (EEFs)
• Certified by the DOI – AB425
• Navigators - $370,000, ~34 individuals in FY 2014
• Enrollment Assisters - $1,826,000, ~169 individuals, FY
2014
• Certified Application Counselors – not paid by Exchange
11
Are EEFs sufficiently trained?
Do we have enough EEFs?
Outreach and Education • Plan for Navigators, Enrollment Assisters and Producers
- 22% of enrollees will use Brokers and Agents
• Paid by carriers
- 30% of enrollees will use Web Portal with the help of a Call Center
• 50 plus individuals in Las Vegas (staff size flexes with
demand)
- 4% of enrollees will use Web Portal alone
12
Can the call center meet demand
(staff size; training)?
Will Brokers step up?
Marketing/Branding/Outreach
• $5,419,900 budget for 15 months
• Contract began January 2013
• Goal: Enroll 118,000 persons, mainly in 138% to
400% of FPL
• Reach hundreds of thousands of Nevadans
directly with outreach
13
Overview of Marketing/Outreach
14
Outreach
• Partnering with numerous
non profits serving this
population
• Presence at events, festivals,
neighborhood venues
• Presentations; Door to door campaign
• Grassroots, person to person approach
15
Will outreach be sufficient?
Nevada Health Link Operated by the Silver State Health Insurance Exchange
2310 South Carson Street, Suite 2
Carson City, NV 89701
(775) 687-9939
www.exchange.nv.gov
We will be ready