Tribal Advi dviso sory W Workgroup October 12, 12, 20 2017 - PowerPoint PPT Presentation

Tribal Advi dviso sory W Workgroup October 12, 12, 20 2017

Tribal Advi dviso sory W Workgroup October er 12, 12, 20 2017 Agend Ag enda 10:00 Welcome and Roll Call (5 min) 10:05 Approval of Meeting Minutes (5 min.) 10:10 Plan Certification & Coverage Areas (15 min) 10:25 Open Enrollment Updates (10 min) 10:35 Call Center Update (10 min) 10:45 Questions/New Issues/Updates (20 min) 11:05 Adjourn 2

Washington Health Benefit Exchange Welcome & & Introductions

Washington Health Benefit Exchange 2018 Plan Certifications and Coverage Areas Christine Gibert, Associate Policy Director

Recent Board Activity: Plan Certification ▪ Board certified 2018 health and dental plans on September 25 ▪ Materials available at: https://www.wahbexchange.org/event/exchange- board-special-meeting-plan-certification/ ▪ Key new issue this year: uncertainty around continued federal payment of cost-sharing reductions (CSRs) 5

2018 Plan Themes ▪ All counties have 2018 QHP options ▪ Premiums increasing because of cost trend and federal uncertainly, particularly enforcement of individual mandate ▪ Deductibles rising ▪ Changes in coverage areas and products offered 6

Overview of Certified 2018 Plans Qualified Health Plans ▪ 41 individual QHPs approved for 2018 ▪ 38 renewals, 3 new QHPs ▪ 7 issuers offering 2018 QHPs ▪ 9 counties have one issuer ▪ Chelan, Douglas, Ferry, Grays Harbor, Island, Pend Oreille, San Juan, Skagit, Skamania Qualified Dental Plans ▪ 6 QDPs ▪ 4 pediatric plans, 2 family plans ▪ Statewide coverage 7

2018 QHPs by Metal Level ▪ Almost half (46%) of QHPs are silver plans ▪ 22% are gold, 27% are bronze ▪ 2 carriers not offering bronze plans in 2018 ▪ 7 counties with no bronze offerings for 2018 ▪ Chelan, Douglas, Ferry, Lincoln, Pend Oreille, Skamania, Stevens ▪ 2 carriers offering catastrophic plans 8

Coverage Area Changes Inside Exchange ▪ Regence and CHPW left the Exchange market ▪ Kaiser of WA and Kaiser NW made no changes ▪ Coordinated Care added 2 counties ▪ Columbia and Kittitas ▪ BridgeSpan offering in Klickitat County only ▪ Premera, LifeWise, and Molina reduced their coverage areas 9

Approved Deductibles for 2018 in the Exchange Gold 2017 2018 Deductible Range $0 - $1,540 $0 - $3,800 Median Deductible $1,200 $1,250 Silver 2017 2018 Deductible Range $0 - $7,150 $1,750 - $7,150 Median Deductible $3,000 $4,500 Bronze 2017 2018 Deductible Range $5,000 - $7,150 $5,000 - $7,150 Median Deductible $6,000 $6,350 10

Accounting for Potential Loss of CSR Funding During PY 2018 ▪ If CSRs lose federal funding, eligible consumers still receive cost-sharing subsidies when they seek services ▪ OIC has approved two sets of rates for each 2018 silver QHP – one set assuming CSR payments are funded and a second set to account for potential termination of CSR payments to issuers ▪ Secondary rates load the cost of CSR payments onto premiums of silver plans offered inside the Exchange ▪ Rates for gold, bronze, and catastrophic plans are not affected 11

Implications of Loss of CSR Funding in 2018 ▪ OIC has indicated that the second set of rates will go into effect with the termination of CSR payments to issuers ▪ Will significantly increase premiums for unsubsidized enrollees in silver plans ▪ Tax credits will increase as premiums increase for subsidized enrollees ▪ Impact on subsidized population will vary because subsidies are based on individuals’ income, not premiums 12

Approved 2018 Silver Plan Rates Carrier 2017 2018 Approved Rate Percent Increase 0f 2018 Rate Approved (CSRs Funded │ CSRs over 2017 Rate Rate Unfunded) (CSRs Funded│CSRs Unfunded) BridgeSpan* $327 $387 │ $492 18% │ 50% Coordinated Care Corp. $230 $299 │ $328 30% │ 42% Kaiser Foundation Health Plan $276 $328 │ $404 19% │ 47% of WA Kaiser Foundation Health Plan $324 $369 │ $435 14% │ 34% of the NW * LifeWise Health Plan of WA* $333 $395 │ $451 19% │ 36% Molina Healthcare of WA $253 $345 │$ 385 37% │ 52% Premera Blue Cross $406 $481 │$ 529 18% │ 30% Rates reflect the approved rate of the lowest-priced Silver plan for a 40 year old non-smoking King County resident in the individual Exchange. *Indicates carrier that is not offering plans in King County; plan rates reflect lowest silver premium in other rating area. 8

Approved 2018 Silver Plan Rates Carrier 2018 Approved Rate – 2018 Approved Rate – Percent Increase – CSRs Continue to be Federal CSR Funding 2018 CSR Rate to 2018 Funded Ceases No CSRs Rate BridgeSpan* $387 $492 27% Coordinated Care Corp. $299 $328 10% Kaiser Foundation Health $328 $404 23% Plan of WA Kaiser Foundation Health $369 $435 18% Plan of the NW * LifeWise Health Plan of $395 $451 14% WA* Molina Healthcare of WA $345 $385 12% Premera Blue Cross $481 $529 10% Rates reflect the approved rate of the lowest-priced Silver plan for a 40 year old non-smoking King County resident in the individual Exchange. *Indicates carrier that is not offering plans in King County; plan rates reflect lowest silver premium in other rating area. 9

Counties with One Issuer for 2018 County Issuer Lowest-priced Metal Level 2018 Plan Chelan Coordinated Care $287 Silver Douglas Coordinated Care $287 Silver Ferry Molina $324 Silver Grays Harbor Premera $430 Bronze Island Kaiser WA $294 Bronze Pend Oreille Molina $324 Silver San Juan Kaiser WA $294 Bronze Skagit Kaiser WA $294 Bronze Skamania Molina $372 Silver Rates reflect the lowest-cost plan available to a 40 year old, non-smoking individual in each county. 8

Lowest Priced Plan by Carrier for 2018 County Lowest Premium for 2018 Metal Level BridgeSpan $326 Bronze Coordinated Care $274 Silver Kaiser NW $268 Bronze Kaiser WA $264 Bronze LifeWise $312 Bronze Molina $324 Silver Premera $387 Bronze Rates reflect the lowest-cost plan available to a 40 year old, non-smoking individual, by carrier. Rates may vary by rating area. 8

Contingency Planning for Loss of CSR Funding ▪ Exchange is developing operational plans to adjust rates, if necessary ▪ Exchange would recalculate tax credits for all subsidized consumers ▪ All consumers would receive a communication ▪ Exchange would work closely with Navigators and brokers to provide support and clarification ▪ Exchange is considering offering a special enrollment period 17

Cross-Mapping ▪ Exchange will re-enroll consumers into their current plan if it is being renewed ▪ ~150,000 enrollees ▪ OIC develops methodology for cross-mapping across carriers ▪ ~30,000 QHP enrollees’ carrier not offering in their county next year ▪ OIC draft cross-mapping plan prioritizes keeping consumers enrolled in the same metal level plan with the same network type (PPO, EPO, HMO, etc.) ▪ If multiple plans available, maps to lowest cost plan 18

Implications for AI/AN Consumers ▪ Bronze options not available in all counties – this is a change from prior years ▪ Sponsors should re-evaluate their options – many changes to plan offerings and service areas ▪ Because some AI/AN members will have silver plans as the lowest-premium plan in 2018, their premiums could go up if CSRs lose funding ▪ Shop and compare – some AI/AN members will bronze plans will be mapped to silver plans, but could have a bronze plan option with another carrier 19

Next Steps for Open Enrollment ▪ OIC has approved use of lower set of rates for open enrollment ▪ Preparing for shift, if OIC approves use of second set of rates (due to federal action) ▪ Consumers receive renewal letters by November 1 ▪ Outreach to customers to encourage them to shop, compare, get in person help if needed 20

Call Center Update Molly Voris

Cus ustomer er Supp upport C Center er: T Tribal Spe pecialty Q Que ueue ▪ Implemented on June 6, 2017 ▪ All call inquiries involving an AI/AN applicant should be referred through this specialty queue. The Customer Support Representative receiving the call follows a call transfer process to hand-off the call to the Tribal Specialty queue. ▪ 10 Customer Support Representatives were trained to handle calls transferred to the Tribal Specialty queue.

Cha hanges f es for OE OE Are C e Coming Specific information for IVR menu will be sent upon implementation Change #1: IVR menu-How to Reach a Tribal Specialist Representative - to be implemented mid to late October ▪ The change will allow the caller to easily speak to a Tribal Specialist. ▪ Upon contacting the HPF Call Center, Callers will be alerted to new menu selections for assistance. To reach a tribal specialist, your call will no longer need to be transferred. The caller will select the Tribal queue to receive assistance from a trained Tribal Specialist Representative. Change #2: Call Center Operating Hours ▪ Open enrollment daily operating hours will begin on November 1.