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Healthcare Taskforce

Why a State-Based Exchange?

Idaho in Control

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

Your Health Idaho Updates, Enrollment and Interest

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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

Questions?