SHOP Advisory Group June 14, 2012 Agenda Welcome & - - PowerPoint PPT Presentation

SHOP Advisory Group

June 14, 2012

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Agenda

− Welcome & Introductions 5 min − Standard Operating Procedures 10 min

• Distribute & Discuss
• Assign Recorder

− SHOP AG Charter Review 10 min − Policies

• Employer & Employee Choice Architecture

40 min

• Single Streamlined (Uniform Enrollment) Application

40 min

− Open Forum 10 min − Wrap-up 5 min

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SHOP Advisory Group Charter

Inform the business processes, tools, and support functions available in the Small Business Health Options Program (SHOP).

The group may address the following issues:

− Inform the design of the COHBE shopping portal, choice architecture and work flow that will guide employers and employees through the health plan selection process − Inform business processes and technologies needed to support broker participation in the Exchange. − Review broker compensation models that could be used by the Exchange. − Discuss the impacts of changing the way business groups of one are defined. − Provide feedback on employer and employee rights and responsibilities. − Define roles of brokers and navigators in the Exchange.

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Topic Summary & Board Target Decision Dates

Employer & Employee Choice Architecture 7/9 Single Streamlined Application TBD Standard Comparative Plan Information 6/25 Broker Relationship & Compensation 7/9 Certification, of Health Issuers & QHP’s 6/25 Customer Service Center 8/27 Consumer & Employer Rights & Responsibilities 8/27

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SHOP Policy & Process Topics Topic Employer & Employee Choice Architecture Essential Question: What is the proper balance between employer/ employee choice and financial viability of plan

• fferings on the SHOP exchange? Should the

exchange specify minimum participation and contribution rates? Target Decision Date – July 9, 2012

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Employer & Employee Choice Architecture Sub-questions

− Should there be restrictions on the number of plans employers can choose from in the Exchange? − Should employers have the choice to provide a defined contribution to their employees? − Will there be a minimum contribution level for traditional plans offered by the employer in the Exchange?

Essential Question: What is the proper balance between employer/employee choice and financial viability of plan offerings on the SHOP exchange? Should the exchange specify minimum participation and contribution rates?

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Employer/Employee Choices

• What are the Exchange options for a framework to

effectively connect employers and health plans in the SHOP?

• What are the Exchange options for a framework that

will enable employees to select a health plan through the SHOP?

• What rules and structure does the Exchange need to

consider regarding employer contributions and participation rates?

• How are these options and decisions interrelated?

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Selection of Plans

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Defined Contributions

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SHOP Policy & Process Topics Topic – Single Streamlined Application

previously called Uniform Enrollment

Essential Question: Is there an advantage to Colorado to create a customer enrollment form, or should COHBE use a standard enrollment form that will support multi-state interoperability & partnership? Target Decision Date – TBD

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Single Streamlined Application Sub-questions

− Will the Exchange use the current Colorado Mandated Uniform Application? − What changes, if any, should be made?

Essential Question: Is there an advantage to Colorado to create a customer enrollment form, or should COHBE use a standard enrollment form that will support multi-state interoperability & partnership?

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SHOP Policy & Process Topics Topic – Standard Comparative Plan Information Essential Question: What is the appropriate information to be displayed to consumers when they are shopping for and comparing qualified health plans? Target Decision Date – June 25, 2012