Washington Health Benefit Exchange SHOP Discussion Exchange - PowerPoint PPT Presentation

Washington Health Benefit Exchange SHOP Discussion Exchange Advisory Committee Meeting December 3, 2015 Molly Voris, Policy Director Beth Walter, Operations Director

SHOP Discussion Topics ▪ Curr rrent lan landscape ▪ Potential l op options ▪ Analysis is needed ▪ Tim imelin ine/Next steps 2

Current Landscape ▪ SH SHOP: : fed ederal l req equirement; t; has as to o be e statewide ▪ Availa lable le to o em employers with ith up to o 50 50 em employees; ; em employer tax x cr credit ▪ Sm Small ll group defin finiti ition not ot goin oing to o 100 100 em employees ▪ Only on one year of of exp xperie ience with ith SH SHOP mar arket ▪ Mod oda with ithdrawn fr from Was ashin ington market, in indiv ivid idual an and SH SHOP ▪ One statewid ide car arrie ier (U (Unit ited); ; Clar lark/Cowlit itz cou ounties have tw two car arrie iers (Un (Unit ited an and Kais aiser) 3

Sept. 2015 SHOP Enrollment ▪ 121 121 employers ▪ 624 624 employees/dependents in in 23 23 cou ounties ▪ Enroll llment compared to o oth other states ▪ CO (th (through 20 2014 14): 2,5 2,521 ▪ MN (th (through Mar arch 8, 8, 20 2015 15): 1,4 1,405 ▪ RI RI (th (through Se September 20 2015 15): : 3,9 3,978 4

Potential Options ▪ Con ontin inue, as as is is ▪ Im Improve SH SHOP fu functionalit ity to o make more use ser frie friendly – resp sponsive to o cu customer feedback ▪ Con ontract with ith a a TPA for fin financia ial/admin inistrative processes (w (would ld mai aintain in ap appli lication in in HPF) ▪ Use another state’s pla latform ▪ Opt ou out of of SHOP (13 (1332 wai aiver - mult lti i year process; or or FFM FFM SH SHOP – expected to o be proposed in in fed regs) 5

Analysis Needed ▪ Curr rrent costs (d (dir irect an and in indir irect) ▪ Small ll group mar arket, as as compared to o ot other states ▪ Car arrie ier part articipation potential ▪ St Stakeholder in input ▪ Pros/cons of of eac ach op option ▪ Cos osts to: o: • Im Impr prove experie ience (fi (fix exis istin ing fun functio ionali lity ty) • Mai aintain in status quo quo • Use se a a TP TPA for or fi financia ial/ l/admin inis istrativ ive pr proc ocesses • Maintain on another state’s platform • Rem emove SHOP fun functio ionali lity ty 6

Next Steps ▪ November: Boa oard Committee dis iscussions ▪ De December: Commit ittee dis iscussions ▪ November-February ry: complete cost/benefit it an analysis is ▪ No November/December: Advis isory Commit ittee/TAC dis iscussions ▪ February ry: Present cost/benefit an anal alysis is to o Boa oard 7

Committee Discussion Questions ▪ Do we need to consider any additional options? ▪ Are there other factors that need to be considered in the analysis? ▪ How does the current small group market landscape affect SHOP? ▪ How can we attract more employers to participate in SHOP? 8