STAFF SUMMARY OF MEETING
HEALTH CARE EXCHANGE
|Time:||01:31 PM to 03:34 PM|
|This Meeting was called to order by|
|This Report was prepared by|
X = Present, E = Excused, A = Absent, * = Present after roll call
|Bills Addressed: ||Action Taken:|
|Overview of Mental Health Benefits Presented by DOI|
Update from the Colorado Health Benefit Exchange
|Witness Testimony and/or Committee Discussion Only|
Witness Testimony and/or Committee Discussion Only
01:32 PM -- Overview of Mental Health Benefits Presented by DOI
Peg Brown, Deputy Commissioner of the Division of Insurance, discussed the mental health benefits that will be available through health insurance plans offered both on the exchange and outside of the exchange after January 1, 2014. She discussed the enactment of House Bill 13-1266, concerning the alignment of state health insurance laws with the requirements of the federal "Patient Protection and Affordable Care Act." In response to a question from Representative McCann about the limitations on the number of mental health visits, Ms. Brown stated the benefits are the same as medical surgical benefits.
01:36 PM -- Update from the Colorado Health Benefit Exchange
Patty Fontneau, Executive Director of Connect for Health Colorado, introduced herself and gave a brief overview of the presentation. She provided a handout to the committee (Attachment A).
Gretchen Hammer, Board Chair of Connect for Health Colorado, provided an update on the board membership and the committee structure of the board, which includes executive, finance, operational, and policy and regulation committee. Ms. Hammer stated the board does not anticipate needing additional legislation to address the operational needs of the health benefit exchange. Ms. Hammer discussed the board's meeting schedule.
Ellen Daehnick, a new Connect for Health Colorado board member, introduced herself to the committee.
Gretchen Hammer discussed the credentials of Sharon O'Hara, the other new member of the board.
Ms. Fontneau discussed the key dates for the exchange, including the beginning of open enrollment on October 1, 2013, and the open enrollment deadline for the individual market on March 31, 2014. She stated that the small business open enrollment period is set by the employer and can be at any time during the year. Ms. Fontneau responded to questions about the open enrollment period. She discussed the triggering events that would allow for special enrollment periods. Dialogue continued about adverse selection and the options available to people who do not purchase insurance during open enrollment period.
Ms. Fontneau said the individual and family marketplace will have 150 health plan choices from ten carriers. She explained that pricing will vary due to age, rating areas, family size, and tobacco usage. She discussed the Cover Your Assets Plan, which are catastrophic plans. Ms. Fontneau discussed the financial assistance applications and the tax credits that will be available to individuals. She discussed the exchange's support network that includes the service center, brokers and agents, health coverage guides who are available for one-on-one support, and the assistance sites.
Ms. Fontneau presented information about the small business marketplace. She stated that employers will be able to choose to offer one or more health insurance carriers. Ms. Fontneau responded to questions about the choices that will be available to small businesses to provide insurance options to their employees and whether people will be able to shop on the individual market if their employer offers health insurance. Dialogue continued about affordable coverage provisions in the federal regulations; the tax credits available to families who have access to health insurance through one family member's employer; and whether family coverage offered by an employer is subject to the affordability threshold. Ms. Hammer responded to questions about family coverage offered by an employer. The committee discussed the possibility of issuing a letter to the federal government about potential affordability issues concerning family plans. Ms. Fontneau responded to questions about the assistance available to small businesses to understand their health insurance options, lifetime and annual limits, and deductibles.
Ms. Fontneau discussed the exchange's customer service center, which is located in Colorado Springs. She discussed the efforts to train agents, brokers, and unpaid certified application counselors. In response to questions from the committee, Ms. Fontneau discussed Medicaid coordination efforts and how the exchange is addressing security and privacy issues.
Ms. Fontneau explained the technology progress of the exchange. She discussed the anonymous shopping feature, the access to tax credits through the exchange, the small business exchange, and the federal data hub. Ms. Fontneau responded to questions about the income verification process, the current level of system testing completion, and the types of system testing that is occurring. She discussed the response teams that will be in place as the exchange goes live and the live chat function. Dialogue continued about the usability of the shopping website. Ms. Hammer stated that the website that is available today is not the shopping site, and the shopping site will not be available until October 1. Ms. Fontneau responded to a question about the call center hours.
Ms. Fontneau discussed the exchange's education, outreach, and communication efforts of the exchange. She continued by discussing the exchange's federal grant funding, which totals over $186 million. Senator Ulibarri requested information about the percentage of Colorado-based vendors that are being utilized by the exchange.
Ms. Fontneau discussed the financial approach and financial sustainability of the exchange. She discussed the long-term financial balance that the exchange is seeking and the potential revenue streams available to the exchange. Ms. Fontneau discussed the high risk pool reserves the exchange receives and the broad market assessment, which is at a maximum $1.80 per policy per month and is not based on the number of people on a policy. She discussed the 1.4 percent administrative fee for 2014, and how the fee compares to the federal exchanges. Ms. Fontneau discussed other revenue sources the exchange may explore in the future, which may include carrier tax credit donations, selling technology solutions, and foundation grants. In response to a question, Ms. Fontneau explained the process that would be undertaken before website advertising would occur. Ms. Fontneau discussed the budgeted expenses of the exchange, which concern technology, operations, and services. Ms. Fontneau stated that many of the technology payments will be made upon delivery of the systems.
Cammie Blais, Chief Financial Officer of Connect for Health Colorado, responded to a question about the budget breakdown, and stated that she would provided the committee with specific budget details following the meeting.
Ms. Fontneau discussed the financial modeling for the exchange. She explained the model assumptions of assessments, tax credit donations, premium trends, CoverColorado reserves, and an annual operating budget of $26 million. She discussed the establishment of a reserve fund and a technology obsolescence fund. Ms. Fontneau responded to questions about the broad market assessment, the administrative fee, and the reserve fund. Discussion occurred concerning the elimination of CoverColorado, whether a state-based subsidy could be established to address affordability of health insurance, the elimination of denial due to pre-existing conditions, and options available to people who do not purchase insurance during the open enrollment period. Ms. Fontneau responded to questions about the availability of materials and assistance in Spanish and other language.
The committee continued to discuss about the exchange's website. Members of the committee complimented the exchange board and staff on the progress of the exchange. Ms. Fontneau responded to questions about health insurance rates, the involvement of potential users in the design and testing of the exchange's shopping website, and the availability of information about the essential health benefits.
Senator Aguilar discussed the committee sending a letter to federal Department of Health and Human Services and the possibility of the committee meeting to address a state-based solution to assist families seeking affordable coverage. Representative Gardner commented on the progress of the exchange.
Senator Aguilar adjourned the committee.