Welcome & Minutes Approval February 19 th , 2015 Michele Eberle, MHBE Plan Management Subi Muniasamay, CIO A service of Maryland Health Benefit Exchange
2015 Open Enrollment Update Michele Eberle, Director PPM A service of Maryland Health Benefit Exchange
Call from CMS to allow individuals additional time to complete enrollment based on overwhelming response and impact to call centers and systems All SBMs agreed to consider, all but three states — Hawaii, Kentucky and Vermont — had announced extensions by Monday afternoon Maryland agreed to allow anyone who was unable to complete their application by midnight on 2/15 until 2/28 to complete enrollment 3
What the Website says Open enrollment to buy a plan for 2015 ended Feb. 15, 2015. However, Maryland Health Connection is allowing people to complete their enrollments until Feb. 28, 2015. You need to have started an application at MarylandHealthConnection.gov or have contacted the call center at 855-642-8572 by Sunday, Feb. 15, to be able to complete the process by Feb. 28. The online application will allow you to check a box to confirm you tried to enroll by the Feb. 15 deadline but were not successful, and you will be able to complete your enrollment by Feb. 28, 2015. If you enroll in a qualified health plan by Feb. 18, your coverage begins March 1, 2015. If you enroll in a QHP from Feb. 19 to Feb. 28, your coverage begins April 1, 2015. Enrollees would not be subject to the federal tax penalty, which allows an exemption for three months without coverage during the calendar year. Enrollment continues year-round at MarylandHealthConnection.gov for people who are eligible for Medicaid. You may also be able buy a plan outside of open enrollment if you have special circumstances such as having a baby, getting married or losing other health coverage. Open enrollment for 2016 begins this fall. 4
By the Numbers 269,062 enrolled through MarylandHealthConnection.gov 84,790 QHP with an APTC – 32% total QHP and Medicaid enrollments – 71% total QHP enrollments 34,986 QHP w/o an APTC – 13% total QHP and Medicaid enrollments – 29% total QHP enrollments 149,286 Medicaid enrollments – 55% total 5
IT Updates Implementation Advisory Committee Meeting February 19, 2015 Presented by: Subramanian Muniasamy CIO, MHBE A service of Maryland Health Benefit Exchange
Agenda CIO Introduction IT Overview M & O Releases Planned Improvements Q & A 7
CIO Introduction Subramanian Muniasamy MD HBX Experience Chief Information Officer • Led and successfully delivered the MD HBX Solution in 7 months as the key management leader from Deloitte Consulting • Led the team to stabilize the Legacy MD HBX system as the Director from Optum/QSSI Joined MHBE on January 07, 2015 Executive summary State & Federal Govt. Experience 17 years experience in designing and building systems for Health and Human • Established an effective governance Service programs like Medicaid, Cash, operating model to manage the Federal SNAP and CHIP Facilitated Marketplace (FFM) Technology and Management Leader, having provided leadership on several • Led the Electronic Submission of Medical high profile large-scale IT programs for Documents (ESMD) program for CMS State and Federal Government • Led the Provider Enrollment Chain Prior Positions Ownership System (PECOS) program for • Director, Optum/QSSI CMS • Senior Manager, Deloitte Consulting • Instrumental in the implementation of Education integrated eligibility (MA, SNAP, Cash and • MBA in Leadership CHIP) solutions for the State of New • Bachelor of Engineering in Electronics & Hampshire (NH) and Commonwealth of Communications Pennsylvania (PA) 8
IT Overview Complete On-Track Planned At Risk M&O Releases January February April June August Planning Planning Planning Planning Planning Requirements Requirements Requirements Requirements Requirements Design / Development Design / Design / Development Design / Development Design / Development Development Testing Testing Testing Testing Testing Implementation Implementation Implementation Implementation Implementation July September Enhancements Functionality Status Functionality Status Renewal functionality reduces the 1095-A reporting functionality reduces Planning Planning burden of manual renewal processing the burden of manual processing and Requirements Requirements and allows consumers to choose allows MD HBX to remain in Design / Development Design / Development whether to actively extend existing compliance with IRS reporting coverage, change coverage, or be standards. Testing Testing auto-assigned a new Implementation Implementation program/coverage group. 1095 & MA D atabase Transition QHP Lower Environment Migration Enrollment Overview Special Projects Documentation supplied by QSSI and is Approximately 3 5% of base 34,986 currently under review by Deloitte applications, 20 % of security and 20% 13% Table schema will be developed once review is of FileNet components have been complete installed in TRN Other Items Legacy HIX Decommissioning Approximately 50% of the Dev/Test Data Synchronization of Passive Renewals Medicaid servers have been powered off (65 APTC Population ( ~ 5000 Individuals ) between 149,286 of 129) Carriers and HBX System 84,790 Medicaid Redetermination will migrate ~ 1 million 55% MHBE Network Upgrade 32% individuals into HBX system. Enhancement to the MHBE VPN, Implement the Extension of open enrollment through active directory, telephone etc.. 2/28 from 2/15 9
M&O Releases January Release Deployed into the production environment on: 1/21/2015 Contained 19 defect fixes Key features include: 508 Compliance updates, language and tool tip updates, and updated special enrollment business rules February Release Scheduled for deployment on: 2/27/2015 Includes fixes to 20 defects Key features include: 834 enrollment file updates, notice and verification updates, update language preferences for brokers April Release Scheduled for deployment on: 4/30/2015 Includes fixes to 15 defects Key features include: disenrollment updates and notices, state income verification interface, carrier template, SBC updates, and 2015 FPL update 10
Planned Improvements Regulatory Operational Business # Enhancement Items Requirement Efficiency Excellence 1 PARIS Interface Auto Enrollment of Medicaid 2 Age-Out Population 3 Emergency Medicaid 4 ECMS/ FileNet Integration 5 CMS 834 Integration Readiness 6 Transitional Medicaid 7 Dental Plans 8 Tobacco Ratings 9 Removal of IDB PARIS – Public Assistance Reporting Information System ECMS – Enterprise Content Management System IDB – Interim Database 11
Q & A 12
2016 SERFF Template Changes JP Cardenas, MHBE PPM A service of Maryland Health Benefit Exchange
2016 SERFF Template Changes Plans & Benefits Template – Plan Attributes The fields HSA Eligible, HSA/HRA Employer Contribution, and HSA/HRA Employer Contribution Amount have been moved from the Benefits Package worksheet to the Cost Share Variances worksheet where they can now be completed for each plan variation. For SHOP Plans – Does this plan offer Composite Rating? Individual plans will auto-populate “No” Child Only Plan ID – no longer required for catastrophic plans Disease Management Programs Offered (optional) – Weight Loss Programs added as a new drop-down option for the 2016 plan year EHB Percent of Total Premium (required) – for on-Marketplace plans abortion services must be excluded from the EHB proportion. Used for subsidy calculation
2016 SERFF Template Changes Plans & Benefits Template – URLs URL for Summary of Benefits & Coverage and Plan Brochure now moved to the Cost Share Variances worksheet. URL for Enrollment Payment (optional) – a link connecting the consumer to a carrier’s payment portal. Please submit formal comment to mhbe.carriers@maryland.gov describing interest in display.
2016 SERFF Template Changes Plans & Benefits Template – General Information, OOP Exceptions, SBC Scenario, Cost Sharing Benefit Explanation (optional) – If edited an EHB variance reason is no longer needed. Subject to Deductible [Tier 1 and 2] – removed from Plan and Benefits Template for the 2016 plan year. AVC will use actual copay and coinsurance drop down values. SBC Scenarios – the fields in this section are now required for QHPs Maximum Out of Pocket and Deductibles – may now allow for per-group or per-person distinctions, i.e. stacked deductibles Cost-sharing fields – “Not Applicable” an option for all fields
2016 SERFF Template Changes Prescription Drug Template – Drug Tier Type and Tier Cost Sharing New Drug Tier Types - “Specialty Drugs,” “Zero Cost Share Preventive Drugs,” and “Medical Service Drugs” - list simplified to eliminate “Only Select Generics” and “Only Select Brands” Pharmacy Cost Sharing Types Columns removed (G, K, O, and S on Formulary Tiers sheet) Copayment and Coinsurance options will align with options on the PBT Copayment and Coinsurance now allowable up to two decimal places Copayment and Coinsurance auto-restraints when selecting ZCS Preventive Drugs and Medical Service Drugs
2016 Plan Certification Standards Michele Eberle, Director PPM A service of Maryland Health Benefit Exchange
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