SHOP Advisory Group June 21, 2012 Agenda Welcome & - PowerPoint PPT Presentation

SHOP Advisory Group June 21, 2012

Agenda − Welcome & Introductions 5 min − 6/14 Meeting Review 5 min − Individual & Health Plan AG updates 10 min − Policies  Standard Comparative Plan Information 20 min  Employer & Employee Choice Architecture 65 min − Public Forum 10 min − Wrap-up 5 min 2

Topic Summary & Board Target Decision Dates Standard Comparative Plan Information 6/25 Employer & Employee Choice Architecture 7/9 Broker Relationship & Compensation 7/23 Customer Service Center 8/27 Consumer & Employer Rights & Responsibilities 8/27 Single Streamlined Application TBD Certification of Health Issuers & QHPs TBD 3

SHOP Policy & Process Topics Topic – Standard Comparative Plan Information Essential Question: What is the appropriate information to be displayed to consumers when they are shopping for and comparing qualified health plans? Target Decision Date – June 25, 2012 4

Standard Comparative Plan Federal Minimum • Premium & Cost Sharing − Tier identification (Platinum, Gold, etc) • Quality Ratings − Enrollee satisfaction survey results • Provider Directory − Medical Loss Ratio (MLR) information • Summary of Benefits & − Transparency of Coverage Measures Coverage Other Information • Deductible • Co-insurance • Actuarial Value • Plan type – HMO, PPO, etc. • Other benefits 5

SHOP Policy & Process Topics Topic Employer & Employee Choice Architecture Essential Question: What is the proper balance between employer/ employee choice and financial viability of plan offerings on the SHOP exchange? Should the exchange specify minimum participation and contribution rates? Target Decision Date – July 9, 2012 6

Employer & Employee Choice Architecture Essential Question: What is the proper balance between employer/employee choice and financial viability of plan offerings on the SHOP exchange? Should the exchange specify minimum participation and contribution rates? Sub-questions − Should there be restrictions on the number of plans employers can choose from in the Exchange? − Should employers have the choice to provide a defined contribution to their employees? − Will there be a minimum contribution level for traditional plans offered by the employer in the Exchange? 7