NVHealthLink - Countdown To October - Governing, June 2013

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NVHealthLink - Countdown To October - Governing, June 2013

  1. 1. Nevada Health Link June 18, 2013 Countdown to October Governing Operated by the Silver State Health Insurance Exchange
  2. 2. Agenda 1. Goals of the Exchange 2. Status of Implementation 3. Finance and Sustainability Plan 4. Outreach and Education Can we do what we say we will do?
  3. 3. Goals of the Exchange • Increase the number of insured persons in Nevada • Measures: Enrollment; uninsured rates • Facilitate the purchase and sale of health insurance • Measures: Satisfaction surveys; appeals rates; unsubsidized enrollment; percent of customers that stay with their plans in subsequent years; budget; PMPM costs 3 Strategic Plan
  4. 4. Goals of the Exchange • Assist qualified employers in the enrollment and purchase of health coverage and the application for subsidies for enrollees • Measures: Employer enrollment; satisfaction surveys • Provide consumer education on matters relating to enrollment in and effective use of health insurance • Measures: Awareness; seminar attendance; satisfaction surveys 4 Strategic Plan
  5. 5. Goals of the Exchange • Assist residents of Nevada with access to programs, premium assistance tax credits and cost-sharing reductions • Measures: Testing; secret shoppers; unscheduled web portal down time; enrollment within one session; enrollment within 7 days 5 Strategic Plan Can we meet these measures?
  6. 6. • Nevada has received Conditional Certification from the Secretary of U.S. HHS to operate a State-Based Exchange • The Exchange Board has approved 35 substantial recommendations of the Advisory Committees 6 Status of the Development and Implementation of Nevada Health Link Are policies appropriate to ensure geographic coverage? Do Nevada policies add cost? New federal regulations?
  7. 7. • IT Implementation is on-time: Eligibility Engine (DWSS/Deloitte) and Business Operations Solution (Exchange/Xerox) will meet the October 1, 2013 deadline for operability 7 Status of the Development and Implementation of Nevada Health Link Will the Federal Hub be ready? Will testing go smoothly? Will certification go smoothly?
  8. 8. • Eleven group carrier onboarding meetings complete (January-May) • Ongoing one on one meetings in tech, ops and fulfillment tracks 8 Status of the Development and Implementation of Nevada Health Link Will QHP rates and plan designs be correct in system? Will enrollment be effectively communicated? Will billing be correct?
  9. 9. Outreach and Education • Plan for Navigators, Enrollment Assisters and Producers - 44% of enrollees will use Exchange Enrollment Facilitators (EEFs) • Certified by the DOI – AB425 • Navigators - $370,000, ~34 individuals in FY 2014 • Enrollment Assisters - $1,826,000, ~169 individuals, FY 2014 • Certified Application Counselors – not paid by Exchange 9 Are EEFs sufficiently trained? Do we have enough EEFs?
  10. 10. Outreach and Education • Plan for Navigators, Enrollment Assisters and Producers - 22% of enrollees will use Brokers and Agents • Paid by carriers - 30% of enrollees will use Web Portal with the help of a Call Center • 50 plus individuals in Las Vegas (staff size flexes with demand) - 4% of enrollees will use Web Portal alone 10 Can the call center meet demand (staff size; training)? Will Brokers step up?
  11. 11. Current State Agency and Exchange Coordination • Medicaid enrollment call centers - All 50 states (regardless of Medicaid expansion decision) should expect increased enrollment due to woodwork effect • Current call centers and Exchange call centers - Where are consumers directed? On promotional material? Applications? - How are calls transferred? • Current and new help - Navigators, Brokers, SHIP volunteers, Insurers - Where do the resources go? 11
  12. 12. Marketing/Branding/Outreach • $5,419,900 budget: January 2013 – March 2014 • Goal: Enroll 118,000 persons, mainly in 138% to 400% of FPL • Reach hundreds of thousands of Nevadans directly with outreach • Focus groups finding: simple, direct messaging – the purchase of health insurance is serious 12
  13. 13. Overview of Marketing/Outreach 13
  14. 14. Outreach • Partnering with numerous non profits serving this population • Presence at events, festivals, neighborhood venues • Presentations; Door to door campaign • Grassroots, person to person approach 14 Will outreach be sufficient?
  15. 15. Nevada Health Link Operated by the Silver State Health Insurance Exchange 2310 South Carson Street, Suite 2 Carson City, NV 89701 (775) 687-9939 contact@exchange.nv.gov www.exchange.nv.gov www.nevadahealthlink.com We will be ready

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