Delaware Health Insurance Marketplace Project Update Delaware Health

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Delaware Health Insurance Marketplace Project Update Delaware Health Care Commission Meeting, August 7, 2013

Delaware Health Insurance Marketplace Project Update Delaware Health Care Commission Meeting, August 7, 2013 www. pcghealth. com

Delaware Marketplace Consumer Assistance Update Leslie Tremberth (PCG) 2

Delaware Marketplace Consumer Assistance Update Leslie Tremberth (PCG) 2

Marketplace Guide Program Ramp-up • In July, the State finalized contracts with four organizations

Marketplace Guide Program Ramp-up • In July, the State finalized contracts with four organizations that will hire and deploy Marketplace Guides throughout Delaware • The four organizations will collectively provide up to 68 FTE Guides to educate consumers about the Marketplace and facilitate enrollment in Qualified Health Plans • Guides will assist all consumers in need of support to determine coverage options in the new healthcare landscape, including expanded Medicaid 3

Marketplace Guides - Contract Awards Ø Brandywine Women’s Health Associates - $1, 444, 642

Marketplace Guides - Contract Awards Ø Brandywine Women’s Health Associates - $1, 444, 642 About 20 Guides - Focused on Small business & Individuals in greater Wilmington area Ø Christiana Care - $555, 050 About 7 Guides - Christiana Care New Castle County locations Ø Delmarva Foundation - $1, 742, 513 About 24 Guides - Focused on Small businesses in all 3 counties and individuals in Kent and Sussex Counties Ø Westside Family Healthcare - $1, 345, 413 About 17 Guides - Statewide coverage Total Contract: $5, 087, 358 Supports approximately 68 Marketplace Guides 4

Marketplace Guides • The contracted organizations have begun hiring individual Marketplace Guides • Prior

Marketplace Guides • The contracted organizations have begun hiring individual Marketplace Guides • Prior to certification, Guides must complete Statedesigned training, pass an examination and complete State and Federal background checks • Formal Guide outreach activities will begin late this month and continue throughout and after the close of the open enrollment period • Outreach plans are being reviewed and the State will work with the organizations to ensure sufficient coverage statewide and to target populations 5

Federal In-Person Assister Entities • The Federal government has been issuing additional guidance on

Federal In-Person Assister Entities • The Federal government has been issuing additional guidance on both the Navigator and Certified Application Counselor programs • Navigator grant awards will be announced on August 15; at least two entities in DE are expected to receive funding • Upon announcement of the Navigator organizations, the State will work quickly to engage with the selected entities and incorporate their outreach and enrollment activities with those of the Marketplace Assisters 6

Certified Application Counselors • Organizations interested in providing Certified Application Counselors must complete an

Certified Application Counselors • Organizations interested in providing Certified Application Counselors must complete an application recently made available on CMS’ Health Insurance Marketplace website: http: //marketplace. cms. gov/helpus/cac-apply. html • Eligible organizations include community health centers or other health care providers, hospitals, and non-federal governmental or non-profit social service agencies • CACs will help consumers to understand, apply for and enroll in coverage through the Marketplace but will not performal outreach activities 7

Federal Marketplace Training • All Federally-contracted assister entities must complete Federal training prior to

Federal Marketplace Training • All Federally-contracted assister entities must complete Federal training prior to conducting any activity related to the Marketplace • The Federal government recently made its agent/broker training available and training for other assisters will be made available in late August 8

Delaware Marketplace Plan Management Update Linda Nemes (DOI) 9

Delaware Marketplace Plan Management Update Linda Nemes (DOI) 9

QHP Review Update State Review • DOI completed its review on 7/30 and submitted

QHP Review Update State Review • DOI completed its review on 7/30 and submitted plans to CMS • All plans submitted were recommended for QHP Certification Complete 7/30 Plan Preview August CMS Certification September • Conducted concurrently with federal review for QHP certification • Allows Issuers an opportunity to ‘preview’ their plans as they would appear on the Federal Marketplace Portal to ensure that all relevant information displays correctly. • CMS to make final QHP Certification in early September • CMS to notify the State once QHP Agreements are signed between CMS and Issuers—early to mid September 10

Next Up--Plan Preview Activities (mid August through early September 2013) Plan Preview is essentially

Next Up--Plan Preview Activities (mid August through early September 2013) Plan Preview is essentially a ‘quality assurance’ process activity between the Issuers, CMS and the State • Conducted concurrently with CMS (federal) review of the state’s recommendations for QHP certification • Provides Issuers with an opportunity to ‘preview’ their plans as they would appear on the Federal Marketplace Portal to ensure that planrelated information displays correctly. Ø Issuers are permitted to correct any errors, and make minor changes only Ø The Delaware Plan Management team will participate in the Plan Preview period, providing information and context to assist CMS/CCIIO and the Issuers during the process • CMS will complete its review and finalize the QHP Certification with Issuers in mid September. 11

Public Consulting Group, Inc. 148 State Street, Tenth Floor, Boston, Massachusetts 02109 (617) 426

Public Consulting Group, Inc. 148 State Street, Tenth Floor, Boston, Massachusetts 02109 (617) 426 -2026, www. publicconsultinggroup. com 12