Washington Health Benefit Exchange SHOP Discussion Exchange - - PowerPoint PPT Presentation

Washington Health Benefit Exchange

Exchange Advisory Committee Meeting December 3, 2015 Molly Voris, Policy Director Beth Walter, Operations Director

SHOP Discussion

SHOP Discussion Topics

▪ Curr rrent lan landscape ▪ Potential l op

• ptions

▪ Analysis is needed ▪ Tim imelin ine/Next steps

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Current Landscape

▪ SH SHOP: : fed ederal l req equirement; t; has as to

• be

e statewide ▪ Availa lable le to

• em

employers with ith up to

• 50

50 em employees; ; em employer tax x cr credit ▪ Sm Small ll group defin finiti ition not

• t goin
• ing to
• 100

100 em employees ▪ Only on

• ne year of
• f exp

xperie ience with ith SH SHOP mar arket ▪ Mod

• da 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

• unties have

tw two car arrie iers (Un (Unit ited an and Kais aiser)

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▪ 121 121 employers ▪ 624 624 employees/dependents in in 23 23 cou

• unties

▪ Enroll llment compared to

• oth
• ther 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

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• Sept. 2015 SHOP Enrollment

Potential Options

▪ Con

• ntin

inue, as as is is ▪ Im Improve SH SHOP fu functionalit ity to

• make more use

ser frie friendly – resp sponsive to

• cu

customer feedback ▪ Con

• ntract 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

• ut of
• f SHOP (13

(1332 wai aiver - mult lti i year process; or

• r FFM

FFM SH SHOP – expected to

• be proposed in

in fed regs)

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Analysis Needed

▪ Curr rrent costs (d (dir irect an and in indir irect) ▪ Small ll group mar arket, as as compared to

• ot
• ther states

▪ Car arrie ier part articipation potential ▪ St Stakeholder in input ▪ Pros/cons of

• f eac

ach op

• ption

▪ Cos

• sts to:
• :
• 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

• r fi

financia ial/ l/admin inis istrativ ive pr proc

• cesses
• Maintain on another state’s platform
• Rem

emove SHOP fun functio ionali lity ty

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Next Steps

▪ November: Boa

• ard 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

• Boa
• ard

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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?

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