nvhealthlink - countdown to october - governing, june 2013
TRANSCRIPT
Nevada Health Link
June 18, 2013
Countdown to October
Governing
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 federal 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?
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
9
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
10
Can the call center meet demand
(staff size; training)?
Will Brokers step up?
Current State Agency and
Exchange Coordination • Medicaid enrollment call centers
- All 50 states (regardless of Medicaid expansion decision)
should expect increased enrollment due to woodwork effect
• Current call centers and Exchange call centers
- Where are consumers directed? On promotional material?
Applications?
- How are calls transferred?
• Current and new help
- Navigators, Brokers, SHIP volunteers, Insurers
- Where do the resources go?
11
Marketing/Branding/Outreach
• $5,419,900 budget: January 2013 – March 2014
• Goal: Enroll 118,000 persons, mainly in 138% to
400% of FPL
• Reach hundreds of thousands of Nevadans
directly with outreach
• Focus groups finding: simple, direct messaging –
the purchase of health insurance is serious
12
Overview of Marketing/Outreach
13
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
14
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
www.nevadahealthlink.com
We will be ready