Date: 06/05/2015

Final
Presentation of Budget and Operating Plan

HEALTH CARE EXCHANGE

Votes: View--> Action Taken:
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12:26 PM -- Presentation of Budget and Operating Plan

Ms. O'Hara, Steven ErkenBrack, member, Connect for Health Colorado Board of Directors, Kevin Patterson, Interim Chief Executive Officer (CEO), Connect for Health Colorado, and Gary Drews, outgoing Interim CEO, Connect for Health Colorado, came to the table.

Mr. Drews referred to the handout titled 2016 Strategic and Financial Plan: Final Draft (Attachment G). He discussed the sustainability of the exchange and the proposed budget. He discussed the strategies and the successes of the exchange. He stated that 145,000 customers enrolled in health insurance through the exchange and half of these customers receive no financial assistance. He told the committee that all counties except one had increased enrollments during second enrollment period and that the exchange collaborated with brokers, health coverage guides (HCGs), carriers, and vendors. He discussed the areas that need to be addressed prior to next open enrollment period, such as the need to simplify technology and improve functionality of the exchange, make the process more consumer-friendly and carrier-friendly, and improve training and communications with brokers and HCGs health coverage guides.

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12:38 PM

Mr. Drews discussed 2016-2018 enrollment projections. He discussed the marketing and outreach strategy for the exchange. He spoke about achieving more aggressive enrollment targets, the lower budget, focusing marketing on harder-to-reach populations, and better coordination of the duel eligibility system. He discussed the current status of the service center and the plan to renegotiate with current vendors for a fixed price, integrated service center including technology, staffing systems, quality, maintenance, and a contract with a medical assistant site. He told the committee that the exchange was awarded a grant by the Colorado Health Foundation to assist with the assistance network. He explained that the upgraded system will help the exchange respond more effectively to customers with complex situations that affect their insurance options. Mr. Drews also spoke about the collaboration between the exchange and a medical assistance site that is able to perform CBMS-related work for the exchange and associated Medicaid customers. Referencing page 15 of the handout, Mr. Drews spoke about the exchange's efforts to enhance the Small Group Marketplace (SHOP).

Mr. Drews continued his presentation by discussing capital and project requirements associated with the exchange. He told the committee that the exchange plans to make capital investments in the shared eligibility system, carrier electronic data interchange improvements, and upgrades to the small business marketplaces. He also told the committee that there are plans to add about 12 new full-time equivalent employees to the exchange staff and reduce the number of contract employees. Mr. Drews reviewed the details of the proposed budget referring to the data provided in the handout. Referring specifically to page 25 of the handout, he spoke about revenue cash balances and estimated total revenue and operating cost. He stated that the revenue from the assessment fees is not realized by the exchange for about another year. Committee discussion followed regarding specific aspects of the budget and financial data. The committee discussed the deficit shown on page 25 of the handout, the forecast of future revenue, the grant received from the Colorado Health Foundation, enrollment projections for the exchange, the advertising budget, outreach to individuals who are saving to pay the penalty for not having insurance rather than purchasing insurance, and payments from Medicaid to the exchange for services provided to Medicaid customers.


01:06 PM

Marcia Benshoof, Chief Strategy and Sales Officer, Connect for Health Colorado, addressed committee concerns about revenue received by the exchange and small business tax credits. She explained that small business tax credits are not offered as an advance premium credit through the exchange, but rather the small business owner may access the tax credit when the business' taxes are filed with the Internal Revenue Service. She suggested that the advantages for employers to go through the exchange are that they must use the exchange to qualify for a tax credit and employees have access to a variety of plans to fit their needs.

Mr. ErkenBrack addressed committee concerns regarding the HICA being distributed across an insurers entire risk pool. He stated that the ACA requires that rates be the same inside the exchange as outside of the exchange.


01:18 PM

Committee discussion followed about the difference between gross individual enrollment and effectuated individual enrollment and the three-month grace period to pay premiums for plans purchased on the exchange. Mr. ErkenBrack explained that gross enrollment is the number of individuals that enroll in a health plan and effectuated enrollment is the number of individuals that actually pay for the plans for which they have enrolled. Mr. ErkenBrack also told the committee that 85 percent of plans sold on the exchange are either silver plans or bronze plans.


01:24 PM

Committee members asked that the exchange staff address the following issues in the next meeting: retention rates, the sustainability of the Colorado HealthOp and its affect on the exchange, the cost to the exchange for allowing consumers three months to pay for their insurance plans, how is the exchange addressing the key learnings identified in the presentation on page 4 of the handout, is there a potential the exchange will need to refund federal grant dollars, the affect the King v. Burwell decision will have on exchange, and the affect on enrollment of changing eligibility status of consumers due to fluctuations in income, loss of a job, or change in family circumstances.